Regional hypothermia for prevention of spinal cord ischemic complications after thoracoabdominal aortic surgery: experience with epidural cooling.

A technique for regional hypothermic protection of spinal cord with epidural cooling during thoracoabdominal aneurysm (TAA) repair has been applied in over 100 patients. Elevation of cerebrospinal fluid pressure during the infusion is the principle technical limitation of the technique. When compared to institutional historic controls, patients treated with epidural cooling had a significant reduction in spinal cord ischemic complications. In patients treated for elective Types I, II, III TAA with epidural cooling, spinal cord complications have been reduced to the 3% range.