Wakabayashi A, Connolly J E
Arch Surg. 1976 Nov;111(11):1186-9. doi: 10.1001/archsurg.1976.01360290020003.
A review of the literature suggests that paraplegia associated with thoracic aortic surgery is preventable if intraoperative hypotension is eliminated, the distal aorta perfused adequately, and the intercostal arteries below T-8 level preserved. A surgical technique has been developed that leaves the posterior aortic wall, preserving the intercostal arteries below the level of T-8, and interspersing a diagonally tailored prosthesis with the aid of left atrial-to-femoral arterial bypass without heparinization. Seven patients with extensive aneurysms involving the entire descending thoracic aorta were operated on successfully by this technique without neurological complications.
文献综述表明，如果消除术中低血压、充分灌注远端主动脉并保留T-8水平以下的肋间动脉，与胸主动脉手术相关的截瘫是可以预防的。已经开发出一种手术技术，该技术保留主动脉后壁，保留T-8水平以下的肋间动脉，并在不进行肝素化的情况下借助左心房至股动脉旁路穿插一个对角剪裁的假体。7例累及整个胸降主动脉的广泛动脉瘤患者通过该技术成功进行了手术，没有出现神经并发症。
