An explanation of the high ‘false-positive’ rate of lower-limb SEPs in descending aorta surgery

Guerit, Jean-Michel;Etienne, Pierre-Yves;Dion, Robert
(1994) Handbook of Spinal Cord Monitoring : Proceedings of the Fifth International Symposium on Spinal Cord Monitoring — ISBN: [9789401046190], p. 135-145, published

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  • Guerit, Jean-MichelUCLouvain
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  • Etienne, Pierre-YvesUCLouvain
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  • Dion, RobertUNamur
    Author
Abstract
The incidence of paraparesis or paraplegia following surgical repair of aneurysms of the thoracic or thoraco-abdominal aorta has been reported to be in the range of 2% to 25%. These complications are likely to occur in two circumstances: first, too long a period of aortic cross-clamping associated with a low distal perfusion pressure (< 60 mmHg); second, the exclusion of critical intercostal or lumbar arteries. The first mechanism can be prevented by short cross-clamping time or an efficient atrio-femoral shunt. The second mechanism can theoretically be prevented by reimplantation on the graft of critical arteries. However, this procedure often has to be performed in a blind fashion and can sometimes uselessly increase the cross-clamping duration, thereby increasing the risk of the occurrence of the former mechanism. Thus, adapting the surgical procedure to on-line monitoring of the spinal cord is likely to improve neurological outcome.
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Guerit, J.-M., Etienne, P.-Y., & Dion, R. (1994). An explanation of the high ‘false-positive’ rate of lower-limb SEPs in descending aorta surgery. In S. J. Jones, M. Hetreed, S. Boyd, N. J. Smith (ed.), Handbook of Spinal Cord Monitoring : Proceedings of the Fifth International Symposium on Spinal Cord Monitoring (p. p. 135-145). Springer. https://doi.org/10.1007/978-94-011-1416-5_18