Cool-Shot Technique to Protect Spinal Cord during Thoracoabdominal Aortic Replacement

Spinal cord injury is a serious risk during surgery to repair aneurysms in the thoracic and abdominal aorta. The authors used cold blood to protect the spinal cord during surgery. They selectively circulated cold blood under high pressure to the intercostal artery during reperfusion after intercostal artery reconstruction to avoid reperfusion injury. This technique may prevent reperfusion injury, and early and delayed postoperative paralysis in patients with intraoperative MEP loss during thoracoabdominal aortic aneurysm surgery.

• 1
  The motor evoked potential disappeared during aortic clamping in nine patients.
• 2
  Six patients recovered completely from aortic clamping release, two showed recovery >50% and one achieved full recovery 3 months later.
• 3
  Permanent motor impairment did not occur.