Commentary: Pharmacologic induction of spinal cord ischemic tolerance: Game changer in thoracoabdominal aneurysm repair?

[摘要] Spinal cord ischemia remains a dreaded and yet incompletely understood complication of thoracoabdominal aortic aneurysm repair. Protagonists are (1) loss of end-arterial perfusion via direct ligation of intercostals; (2) ischemia–reperfusion phenomenon during crossclamp of aortic segments and subsequent restoration of flow; and (3) creation of watershed territories with perfusion through intercostal patches and collaterals from above and below the resected segment. Aortic surgeons have multiple strategies aimed at reducing the risk of paraplegia.

[学科分类] 心脏病和心血管学