Reversal of twice-delayed neurologic deficits with cerebrospinal fluid drainage after thoracoabdominal aneurysm repair: A case report and plea for a national.

Slides:

Advertisements

Similar presentations

Endothelial cell seeding reduces thrombogenicity of Dacron grafts in humans Per Örtenwall, MD, PhD *, Hans Wadenvik, MD, PhD **, Jack Kutti, MD, PhD **,

Advertisements

The risk of ischemic spinal cord injury in patients undergoing graft replacement for thoracoabdominal aortic aneurysms Klaus Grabitz, MD, Wilhelm Sandmann,

Heparin-coated catheters and heparin-induced thrombocytopenia

Martorell's hypertensive ischemic leg ulcers are secondary to an increase in the local vascular resistance Henry J. Duncan, B.M., B.S., Irwin B. Faris,

Axillary-to-carotid artery bypass grafting for symptomatic severe common carotid artery occlusive disease Joseph P. Archie, PhD, MD Journal of Vascular.

Analysis of motor and somatosensory evoked potentials during thoracic and thoracoabdominal aortic aneurysm repair Kourosh Keyhani, DO, Charles C. Miller,

Ultrasound measurement of the luminal diameter of the abdominal aorta and iliac arteries in patients without vascular disease Ole Martin Pedersen, MD,

Protocol implementation of selective postoperative lumbar spinal drainage after thoracic aortic endograft Charles J. Keith, BA, Marc A. Passman, MD,

Risk factors, outcomes, and clinical manifestations of spinal cord ischemia following thoracic endovascular aortic repair Brant W. Ullery, MD, Albert.

Strategies to Manage Paraplegia Risk After Endovascular Stent Repair of Descending Thoracic Aortic Aneurysms Albert T. Cheung, MD, Alberto Pochettino,

Complications of lumbar drainage after thoracoabdominal aortic aneurysm repair Kyle D. Weaver, MDa, Diana B. Wiseman, MDa, Mark Farber, MDb, Matthew G.

Jay K. Bhama, MD, Peter H. Lin, MD, Theodoros Voloyiannis, MD, Ruth L

Postoperative risk factors for delayed neurologic deficit after thoracic and thoracoabdominal aortic aneurysm repair: A case-control study Ali Azizzadeh,

Mycotic axillary artery aneurysm

Mina L. Boutrous, MD, Rana O. Afifi, MD, Hazim J. Safi, MD, Anthony L

Asymptomatic internal carotid artery aneurysm

Walter J. Scott, M.D., Bruce L. Gewertz, M.D.

Effects of exercise rehabilitation on cardiovascular risk factors in older patients with peripheral arterial occlusive disease Anna Maria Izquierdo-Porrera,

Analysis of motor and somatosensory evoked potentials during thoracic and thoracoabdominal aortic aneurysm repair Kourosh Keyhani, DO, Charles C. Miller,

Intracerebral hemorrhage after carotid endarterectomy: Incidence, contribution to neurologic morbidity, and predictive factors Kenneth Ouriel, MD, Cynthia.

Postoperative renal function preservation with nonischemic femoral arterial cannulation for thoracoabdominal aortic repair Charles C. Miller, PhD, Joshua.

Descending thoracic aortic aneurysm: surgical approach and treatment using the adjuncts cerebrospinal fluid drainage and distal aortic perfusion Anthony.

Malcolm O. Perry, MD, Richard Kempczinski, MD

Transaortic endarterectomy of renal visceral artery lesions in association with infrarenal aortic surgery Robert A. Mason, MD, George B. Newton, MD,

Anthony L. Estrera, MD, Roy Sheinbaum, MD, Charles C

Protecting the brain and spinal cord

Risk factors, outcomes, and clinical manifestations of spinal cord ischemia following thoracic endovascular aortic repair Brant W. Ullery, MD, Albert.

Heparin-coated catheters and heparin-induced thrombocytopenia

Use of duplex imaging to assess suitability of the internal mammary artery for coronary artery surgery Charles C. Canver, MD, John J. Ricotta, MD, Joginder.

Effects of thoracic aortic occlusion and cerebrospinal fluid drainage on regional spinal cord blood flow in dogs: Correlation with neurologic outcome

Andrew W. Bradbury, BSc, MD, FRCSEd, Paul Bachoo, FRCS, Alan A

Hazim J. Safi, MD, Charles C

Ruptured ovarian artery aneurysm: A case report

Thoracoabdominal aortic aneurysms associated with celiac, superior mesenteric, and renal artery occlusive disease: Methods and analysis of results in.

Charles W. Acher, MD, Martha M. Wynn, MD, John R. Hoch, MD, Paul W

Venous photoplethysmography: Relationship between transducer position and regional distribution of venous insufficiency Stefan Rosfors, MD Journal of.

Impact of distal aortic and visceral perfusion on liver function during thoracoabdominal and descending thoracic aortic repair Hazim J. Safi, MD, Charles.

Giancarlo Piano, MD, Bruce L. Gewertz, MD Journal of Vascular Surgery

Objective tinnitus resulting from internal carotid artery stenosis

Aneurysms of the mid axillary artery in major league baseball pitchers—A report of two cases George J. Todd, MD, Alan I. Benvenisty, MD, Stuart Hershon,

Glomerular filtration rate is a predictor of mortality after endovascular abdominal aortic aneurysm repair Ali Azizzadeh, MD, Luis A. Sanchez, MD, Charles.

Combined use of cerebral spinal fluid drainage and naloxone reduces the risk of paraplegia in thoracoabdominal aneurysm repair C.W. Acher, MD, M.M. Wynn,

G. W. H. Schurink, MD, J. M. van Baalen, MD, M. J. T. Visser, MD, J. H

Transarterial wall oxygen gradients at a prosthetic vascular graft to artery anastomosis in the rabbit Steven M. Santilli, MD, PhD, Shane E. Wernsing,

Journal of Vascular Surgery Volume 34, Issue 6, Pages (December 2001)

Calvin B. Ernst, MD Journal of Vascular Surgery

Ruptured abdominal aortic aneurysm: A population-based study

Ramesh Lokanathan, MD, FRCS(C), David C. Taylor, MD, FRCS(C)

Predictive value of transcutaneous oxygen pressure and amputation success by use of supine and elevation measurements J.Michael Bacharach, MD, Thom W.

Gastrointestinal complications after descending thoracic and thoracoabdominal aortic repairs: A 14-year experience Paul E. Achouh, MD, Ken Madsen, MD,

Journal of Vascular Surgery

J. Kenneth Davison, MD, Richard P. Cambria, MD, David J

Noninvasive carotid artery evaluation following endarterectomy

A prospective randomized study of cerebrospinal fluid drainage to prevent paraplegia after high-risk surgery on the thoracoabdominal aorta E.Stanley.

Atherosclerotic aneurysm of the intrathoracic subclavian artery: A case report and review of the literature Matthew J. Dougherty, MD, Keith D. Calligaro,

Seizures following subclavian-carotid bypass

Monitoring vascular surgical performance

Toe pressure determination by audiophotoplethysmography

Presidential address: The second-generation vascular surgeon

George D. Lilly 1906–1988 Journal of Vascular Surgery

James A. DeWeese, MD Journal of Vascular Surgery

Left subclavian artery aneurysm: Two cases of rare congenital etiology

Axillary-to-carotid artery bypass grafting for symptomatic severe common carotid artery occlusive disease Joseph P. Archie, PhD, MD Journal of Vascular.

Neurologic deficit in patients at high risk with thoracoabdominal aortic aneurysms: The role of cerebral spinal fluid drainage and distal aortic perfusion

Descending Thoracic Aortic Aneurysm Repair: 12-Year Experience Using Distal Aortic Perfusion and Cerebrospinal Fluid Drainage Anthony L. Estrera, MD,

Popliteal entrapment syndrome: A report of tibial nerve entrapment

Hazim J. Safi, MD, Anthony L. Estrera, MD, Charles C

Hazim J. Safi, MD, Stuart A. Harlin, MD, Charles C

Neuromonitor-guided repair of thoracoabdominal aortic aneurysms

Endovascular repair of two abdominal aortic aneurysms

Presentation transcript:

Reversal of twice-delayed neurologic deficits with cerebrospinal fluid drainage after thoracoabdominal aneurysm repair: A case report and plea for a national database collection Ali Azizzadeh, MD, Tam T.T. Huynh, MD, Charles C. Miller, PhD, Hazim J. Safi, MD Journal of Vascular Surgery Volume 31, Issue 3, Pages 592-598 (March 2000) DOI: 10.1067/mva.2000.102328 Copyright © 2000 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 A , Correlation between CSF pressure and neurologic function. The patient had delayed onset paraplegia (Tarlov score 0) at 6 hours after the operation, with a CSF pressure of 17 mm Hg. With prompt CSF drainage, CSF pressure was lowered to below 10 mm Hg and the patient regained leg movements (Tarlov score 4) within the next hour. At 34 hours after the operation, the patient again became paraplegic (Tarlov score 4), with CSF pressure elevated to 12 mm Hg. Although the CSF pressure elevation was due to lumbar catheter occlusion, this was not recognized for 6 hours. A new lumbar drain was then inserted, and CSF drainage was reinstituted, with resolution of the neurologic deficits over the next 12 hours. Time-point zero denotes the time the patient was admitted to the intensive care unit. The different Tarlov scores are defined in Appendix I. B , Postoperative fluctuations in systolic arterial pressure (SBP ) and mean arterial pressures (MAP ). There were no significant changes in mean or systolic arterial pressures during the periods of neurologic deficits. Values shown are the mean ± SD. Time-point zero denotes the time the patient was admitted into the intensive care unit. *Duration of the first delayed paraplegia event; **duration of the second delayed paraplegia event. Journal of Vascular Surgery 2000 31, 592-598DOI: (10.1067/mva.2000.102328) Copyright © 2000 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 Sagittal T2-weighted magnetic resonance images of the upper (A) and lower (B) spinal cord obtained on postoperative day 15 showed no evidence of infarction. Arrows denote the outline of the spinal cord. Journal of Vascular Surgery 2000 31, 592-598DOI: (10.1067/mva.2000.102328) Copyright © 2000 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions