The use of neuromonitoring in descending and thoraco-abdominal aortic aneurysm surgery. Literature Review

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International Journal on Smart Sensing and Intelligent Systems

Professor Subhas Chandra Mukhopadhyay

Exeley Inc. (New York)

Subject: Computational Science & Engineering, Engineering, Electrical & Electronic

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VOLUME 7 , ISSUE 5 (December 2014) > List of articles

Special issue ICST 2014

The use of neuromonitoring in descending and thoraco-abdominal aortic aneurysm surgery. Literature Review

Matthew Fok * / Mohamad Bashir / Thomas Kennedy / Mark Field / Alex Mason

Keywords : Thoracic aortic aneurysm, thoracoabdominal aneurysm, neuromonitoring, spinal cord ischaemia, biosensors

Citation Information : International Journal on Smart Sensing and Intelligent Systems. Volume 7, Issue 5, Pages 1-5, DOI: https://doi.org/10.21307/ijssis-2019-074

License : (CC BY-NC-ND 4.0)

Published Online: 15-February-2020

ARTICLE

ABSTRACT

Without surgical repair thoracic aortic aneurysms are a lethal disease with poor prognosis. An extensive major operation is required to correct an aneurysm that involves the descending or thoracoabdominal aorta. Particular considerations must be made to protection of all abdominal organs, the brain and the spinal cord which are all at risk. Consequently there is a risk that these patients post operatively wake up paraplegic from spinal cord ischaemia due to the nature of the surgery. Certain techniques have evolved that have considerably reduced this risk. Neuromonitoring is a technique that can provide an intraoperative assessment of the integrity of the spinal cord through stimulation of nervous pathways and detection in either peripheral muscles or the brain cortex. In theory this can alert the surgical team to impending spinal cord ischaemia and change the management of this patient to prevent paraplegia. However, there is much ambiguity surrounding its use, with no conclusive evidence to prove this technique effectively reduces the rates of paraplegia. This literature review will assess the current methods of neuromonitoring in thoracoabdominal aneurysm repair.

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REFERENCES

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