[Application of evoked potentials monitoring in total thoracoabdominal aorta aneurysm repair]

Zhonghua Yi Xue Za Zhi. 2016 Apr 5;96(13):1007-10. doi: 10.3760/cma.j.issn.0376-2491.2016.13.005.
[Article in Chinese]

Abstract

Objective: To evaluate the application value of evoked potentials (EP) monitoring in patients undergoing aorta-iliac bypass for total thoracoabdominal aorta aneurysm repair (tTAAAR).

Methods: A prospective study, with a total of 31 patients undergoing tTAAAR and intraoperative EP monitoring from June 2014 to April 2015 was carried out. The results of intraoperative evoked potentials, clinical outcomes and follow-up data of patients were collected for further evaluation.

Results: The EP wave disappeared [motor evoked potentials for (55.6±18.1) min, somatosensory evoked potentials for (50.3±18.7) min] after proximal descending aorta being clamped, and gradually recovered after the segment arteries of spine cord were reconstructed. The EP wave was restored to normal level at the end of operation in all the cases. The somatosensory evoked potentials remained unchanged in 2 cases (false negative). One case died after operation. No spinal cord injury occurred. The median follow-up after operation was 10 months (5-14 months). There was no delayed neurological deficit.

Conclusion: EP provided an on-line monitoring of the condition of spinal cord function, which become an intraoperative protocol to avoid the irreversible injury of spinal cord.

MeSH terms

  • Aortic Aneurysm, Thoracic / diagnosis
  • Aortic Aneurysm, Thoracic / physiopathology
  • Aortic Aneurysm, Thoracic / surgery*
  • Evoked Potentials, Motor*
  • Evoked Potentials, Somatosensory*
  • Humans
  • Monitoring, Intraoperative*
  • Plastic Surgery Procedures
  • Prospective Studies
  • Vascular Surgical Procedures / methods*