oa Cardiovascular Journal of Africa - Spinal cord protection in descending thoracic aortic surgery
Descending thoracic aortic surgery is invariably associated with a risk of paraplegia. Spinal cord ischaemia occurs as a result of intra-operative systemic hypotension, occlusion or hypoperfusion of a major radicular artery or from increased cerebrospinal fluid pressure. The risk of causing spinal cord ischaemia is modified by the underlying pathological process. Hence, the incidence of paraplegia complicating surgery varies from 0,4% after aortic coarctation repair to 30% after aortic replacement for type II thoraco-abdominal aneurysm. Various peri-operative techniques can be used to diminish the risk of paraplegia in identifiable high-risk patients or groups.
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