Endovascular repair and open repair surgery of thoraco‑abdominal aortic aneurysms cause drastically different types of spinal cord injury

Scientific Reports, 2021 · DOI: 10.1038/s41598-021-87324-6 · Published: April 20, 2021

Spinal Cord Injury Cardiovascular Science Surgery

Simple Explanation

This study compares spinal cord injury caused by endovascular repair (EVR) and open repair (OR) surgeries for thoraco-abdominal aortic aneurysms. The research used a dog model to examine the different injury patterns and found that EVR leads to white matter damage, while OR causes gray matter damage. The findings suggest that treatments for spinal cord injury after these surgeries should be tailored to the specific type of damage caused by each procedure.

Study Duration

9 Days

Participants

11 male Greyhound dogs

Evidence Level

Not specified

Key Findings

1
EVR causes white matter damage in the spinal cord, particularly affecting the dorsal column medial lemniscus area.
2
OR leads to massive neuronal loss in the gray matter of the spinal cord.
3
Metabolome analysis reveals distinct chemical fingerprints associated with cellular processes in both EVR and OR interventions.

Research Summary

This study investigates the differing impacts of endovascular repair (EVR) and open repair (OR) on spinal cord injury using a canine model. The results indicate that EVR primarily causes white matter damage, while OR leads to gray matter damage, as confirmed by MRI, histopathology, and metabolome analysis. The study concludes that the pathophysiological mechanisms of spinal cord injury differ significantly between EVR and OR, necessitating tailored therapeutic interventions.

Practical Implications

Tailored Therapies

Develop specific treatments for spinal cord injury based on whether EVR or OR was performed, addressing the distinct white matter or gray matter damage.

Improved Monitoring

Implement advanced monitoring techniques to detect early signs of white matter damage following EVR, enabling timely intervention.

Surgical Refinement

Refine surgical techniques for both EVR and OR to minimize the risk of spinal cord injury, focusing on preserving blood flow and reducing ischemic events.

Study Limitations

1
Small sample size of dogs in the study.
2
Lack of aortic aneurysms in the animal model, which may not fully replicate the clinical scenario.
3
Difficulty in achieving significant statistical power analysis due to the prohibitive costs of stenting.

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