Key result
A systematic approach emphasizing collateral blood flow, moderate hypothermia, and endorphin receptor blockade resulted in a 10-fold reduction in paraplegia risk in elective patients.
Why the study?
Does a systematic approach emphasizing collateral blood flow, moderate hypothermia, and endorphin receptor blockade reduce paraplegia risk in patients undergoing surgical treatment of thoracoabdominal aortic aneurysms?
Does a systematic approach emphasizing collateral blood flow, moderate hypothermia, and endorphin receptor blockade reduce paraplegia risk in patients undergoing surgical treatment of thoracoabdominal aortic aneurysms?
Effect estimate: 10-fold reduction in elective patients, 5-fold reduction in acute patients
A systematic surgical approach emphasizing collateral blood flow, moderate hypothermia, and endorphin receptor blockade substantially reduces paraplegia risk and improves survival in thoracoabdominal aortic aneurysm surgery.
May not yet alter practice in thoracoabdominal aortic aneurysm repair; leaves open need for prospective validation of this approach.
A systematic approach to paraplegia risk in the surgical treatment of thoracoabdominal aortic aneurysms based on effective strategies identified from the experimental literature is discussed. With this approach, collateral blood flow, rather than direct intercostal reimplantation, moderate hypothermia and endorphin receptor, is emphasized blockade. The result has been a 10-fold reduction in paraplegia risk in elective patients and a 5-fold reduction in acute patients. This reduction in paralysis risk has resulted in improved short- and long-term survival.
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Charles W. Acher (1999) studied Thoracoabdominal aortic aneurysms. Systematic approach emphasizing collateral blood flow, moderate hypothermia, and endorphin receptor blockade vs. Direct intercostal reimplantation was evaluated on Paraplegia risk (10-fold reduction in elective patients, 5-fold reduction in acute patients). A systematic approach emphasizing collateral blood flow, moderate hypothermia, and endorphin receptor blockade resulted in a 10-fold reduction in paraplegia risk in elective patients.
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