Failure of motor evoked potentials to predict neurologic outcome in experimental thoracic aortic occlusion  James R. Elmore, MD, Peter Gloviczki, MD,

Slides:



Advertisements
Similar presentations
The role of arteriovenous shunts in the pathogenesis of varicose veins Howard C. Baron, M.D., Sebastiano Cassaro, M.D. Journal of Vascular Surgery Volume.
Advertisements

The effect of inguinal lymphatic manipulation on regional lymph flow patterns Jeffrey R. Rubin, MD, Lisa B. Eberlin, MD Journal of Vascular Surgery Volume.
Exploring Spinal Cord Protection by Remote Ischemic Preconditioning: An Experimental Study  Johanna Herajärvi, MD, Tuomas Anttila, MB, Henna Sarja, MB,
The risk of ischemic spinal cord injury in patients undergoing graft replacement for thoracoabdominal aortic aneurysms  Klaus Grabitz, MD, Wilhelm Sandmann,
Resveratrol, a Natural Red Wine Polyphenol, Reduces Ischemia-Reperfusion–Induced Spinal Cord Injury  Sadi Kaplan, MD, Gianluigi Bisleri, MD, Jeffrey A.
Aortic injury occurring after minor trauma in ankylosing spondylitis
Role of nitric oxide and tumor necrosis factor on lung injury caused by ischemia/reperfusion of the lower extremities  Apostolos K. Tassiopoulos, MD,
Prevention of paraplegia during thoracic aortic cross-clamping: Importance of patent internal mammary arteries  Joseph S. Giglia, MD, Gerald B. Zelenock,
Jeanwan Kang, MD, Hassan Albadawi, MD, Patrick J. Casey, MD, Thomas A
Graft-related complications after abdominal aortic aneurysm repair: Reassurance from a 36-year population-based experience  John W. Hallett, MD, Donna.
Christopher K. Zarins, MD, Chengpei Xu, MD, Seymour Glagov, MD 
Gastroesophageal tumor embolization to the popliteal arteries
Early ischemic preconditioning without hypotension prevents spinal cord injury caused by descending thoracic aortic occlusion  Ioannis K. Toumpoulis,
Superiority of early relative to late ischemic preconditioning in spinal cord protection after descending thoracic aortic occlusion  Ioannis K. Toumpoulis,
Controlled low-pressure perfusion at the beginning of reperfusion attenuates neurologic injury after spinal cord ischemia  Enyi Shi, MD, PhD, Xiaojing.
Ischemic postconditioning protects the spinal cord from ischemia–reperfusion injury via modulation of redox signaling  Wenying Song, MD, Jing Sun, MD,
Reduction of ischemic spinal cord injury by dextrorphan: Comparison of several methods of administration  Hitoshi Terada, MD, Teruhisa Kazui, MD, Makoto.
Abdominal aortic pseudoaneurysm after blunt trauma
David Rosenthal, MD, Southern Association for Vascular Surgery 
Loic Lang-Lazdunski, MDa,b. , Catherine Heurteaux, PhDb
The adverse effect of back-bleeding from lumbar arteries on spinal cord pathophysiology in a rabbit model  Yujiro Kawanishi, MD, Kenji Okada, MD, Hiroshi.
Tetramethylpyrazine protects spinal cord and reduces inflammation in a rat model of spinal cord ischemia-reperfusion injury  Lihong Fan, MD, Kunzheng.
Aortic injury occurring after minor trauma in ankylosing spondylitis
Prevention of ischemic spinal cord injury: Comparative effects of magnesium sulfate and riluzole  Loïc Lang-Lazdunski, MD, Catherine Heurteaux, PhD, Hervé.
Resveratrol, a Natural Red Wine Polyphenol, Reduces Ischemia-Reperfusion–Induced Spinal Cord Injury  Sadi Kaplan, MD, Gianluigi Bisleri, MD, Jeffrey A.
Walter J. Scott, M.D., Bruce L. Gewertz, M.D. 
Role of nitric oxide and tumor necrosis factor on lung injury caused by ischemia/reperfusion of the lower extremities  Apostolos K. Tassiopoulos, MD,
Prevention of paraplegia in pigs by selective segmental artery perfusion during aortic cross-clamping  Sven A. Meylaerts, MDa, Peter de Haan, MD, PhDb,
Endothelium-dependent vasorelaxations in response to aggregating platelets are impaired in reversed vein grafts  Kimihiro Komori, MD, Peter Gloviczki,
The neuroprotective effects of intrathecal administration of the selective N-type calcium channel blocker ziconotide in a rat model of spinal ischemia 
Strategies to prevent neurologic deficit based on motor-evoked potentials in type I and II thoracoabdominal aortic aneurysm repair  Michael J.H.M. Jacobs,
Neuroprotection following mild hypothermia after spinal cord ischemia in rats  Takeshi Saito, PhD, Shino Saito, MD, Hiroshi Yamamoto, MD, PhD, Masanori.
John Blebea, MD, John C. Kerr, BA, Charles D. Franco, MD, Frank T
Malcolm O. Perry, MD, Richard Kempczinski, MD 
Protecting the brain and spinal cord
Interleukin-1 receptor antagonist attenuates the severity of spinal cord ischemic injury in rabbits  Satoshi Akuzawa, MD, Teruhisa Kazui, MD, PhD, Enyi.
David A. Zvara, MD, David M. Colonna, MD, Dwight D. Deal, BS, Jason C
Effects of thoracic aortic occlusion and cerebrospinal fluid drainage on regional spinal cord blood flow in dogs: Correlation with neurologic outcome 
James E. Chapman, M.D., William Allen Loy, M.D. 
Dose-dependent neuroprotection of delta-opioid peptide [D-Ala2, D-Leu5] enkephalin on spinal cord ischemia-reperfusion injury by regional perfusion into.
Dissection of the external iliac artery in highly trained athletes
Spinal cord injury in experimental thoracic aortic occlusion: investigation of combined methods of protection  James R. Elmore, MD, Peter Gloviczki, MD,
Remote ischemic preconditioning protects the spinal cord against ischemic insult: An experimental study in a porcine model  Henri Haapanen, MD, Johanna.
Thrombolysis for experimental deep venous thrombosis maintains valvular competence and vasoreactivity  Jeffrey M. Rhodes, MD, Jae-Sung Cho, MD, Peter.
Giancarlo Piano, MD, Bruce L. Gewertz, MD  Journal of Vascular Surgery 
Ugursay Kiziltepe, MD, N. Nilufer D Turan, PhD, Unsal Han, MD, A
Transesophageal versus transcranial motor evoked potentials to monitor spinal cord ischemia  Kazumasa Tsuda, MD, Norihiko Shiiya, MD, PhD, Daisuke Takahashi,
New method for absolute spinal cord ischemia protection in rabbits
Ischemic preconditioning ameliorates spinal cord ischemia-reperfusion injury by triggering autoregulation  Cheng-Loong Liang, MD, Kang Lu, MD, PhD, Po-Chou.
Jae-Sung Cho, MD, Peter Gloviczki, MD, Eugenio Martelli, MD, W
Primary leiomyosarcoma of the abdominal aorta
Determinants of ischemic injury to skeletal muscle
Angioscope-assisted occlusion of venous tributaries with prolamine in in situ femoropopliteal bypass: Preliminary results of canine experiments  John.
Glucagon potentiates intestinal reperfusion injury
Myogenic transcranial motor evoked potentials monitoring cannot always predict neurologic outcome after spinal cord ischemia in rats  Manabu Kakinohana,
Calvin B. Ernst, MD  Journal of Vascular Surgery 
James R. Burnett, MB, BS, FRACS, Robert J. Lusby, MD, FRCS, FRACS 
The adenosine triphosphate–sensitive potassium channel opener nicorandil protects the ischemic rabbit spinal cord  Yutaka Wakamatsu, MDa, Norihiko Shiiya,
Infected femorodistal bypass: Is graft removal mandatory?
Ischemia-reperfusion injury of the spinal cord: Protective effect of the hydroxyl radical scavenger dimethylthiourea  Willem Wisselink, MD, Samuel R.
Gary W. Barone, MD, Axel W. Joob, MD, Terry L. Flanagan, MPH, Carey E
Monitoring of intrathecal oxygen tension during experimental aortic occlusion predicts ultrastructural changes in the spinal cord  Anders Hellberg, MDa,
Richard J. Sanders, MD 1, William H. Pearce, MD 2 
Strategies to prevent neurologic deficit based on motor-evoked potentials in type I and II thoracoabdominal aortic aneurysm repair  Michael J.H.M. Jacobs,
Acute aortic occlusion – Factors that influence outcome
Direct noninvasive monitoring of spinal cord motor function during thoracic aortic occlusion: Use of motor evoked potentials  John C. Laschinger, M.D.,
Presidential address: The second-generation vascular surgeon
Influence of preservation or perfusion of intraoperatively identified spinal cord blood supply on spinal motor evoked potentials and paraplegia after.
George D. Lilly 1906–1988 Journal of Vascular Surgery
James A. DeWeese, MD  Journal of Vascular Surgery 
Presentation transcript:

Failure of motor evoked potentials to predict neurologic outcome in experimental thoracic aortic occlusion  James R. Elmore, MD, Peter Gloviczki, MD, C.Michel Harper, MD, Peter C. Pairolero, MD, Michael J. Murray, MD, Russell G. Bourchier, MB, ChB, Thomas C. Bower, MD, Jasper R. Daube, MD  Journal of Vascular Surgery  Volume 14, Issue 2, Pages 131-139 (August 1991) DOI: 10.1067/mva.1991.29237 Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Canine model used to evaluate MEP and SEP monitoring during thoracic aortic occlusion. Journal of Vascular Surgery 1991 14, 131-139DOI: (10.1067/mva.1991.29237) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Motor evoked potential and SEP sample recordings in a control animal without CSF drainage and resultant paraplegia. Note persistence of MEPs with loss of SEPs. Somatosensory evoked potentials return after reperfusion with prolonged latencies. Journal of Vascular Surgery 1991 14, 131-139DOI: (10.1067/mva.1991.29237) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Amplitude and latency of MEPs. Amplitude data expressed as a percentage of baseline (mean ± SEM). Latency data expressed as a prolongation over baseline in milliseconds (mean ± SEM). No significant difference between neurologically injured and normal dogs. Journal of Vascular Surgery 1991 14, 131-139DOI: (10.1067/mva.1991.29237) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Amplitude and latency of SEPs. Amplitude data expressed as a percentage of baseline (mean ± SEM). Latency data expressed as a prolongation over baseline in milliseconds (mean ± SEM). No significant difference between neurologically injured and normal dogs at 30 minutes of occlusion. Ninety-five percent of injured dogs lost SEPs by 60 minutes so no data analysis at that time interval. Note significant prolongation in latencies of SEPs during reperfusion. Journal of Vascular Surgery 1991 14, 131-139DOI: (10.1067/mva.1991.29237) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 5 Spinal cord blood flow in low thoracic and lumbar gray matter. Data expressed as median blood flow in ml/100 gm/min. Significantly decreased flow in neurologically injured dogs during the cross-clamp time. Journal of Vascular Surgery 1991 14, 131-139DOI: (10.1067/mva.1991.29237) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 6 Light micrograph of proximal lumbar spinal cord gray matter of paraplegic control animal. Histologically there is anterior horn cell degeneration with ischemia of surrounding neural tissue. The three anterior horn cells in the top right corner are normal, whereas the three anterior horn cells in the center exhibit features of ischemic necrosis. (Hematoxylin-eosin stain; original magnification ×400.) Journal of Vascular Surgery 1991 14, 131-139DOI: (10.1067/mva.1991.29237) Copyright © 1991 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions