Recovery of lost motor evoked potentials in open thoracoabdominal aortic aneurysm repair using intercostal artery bypass

Alexander Gombert; Jochen Grommes; Danny Hilkman; Drosos Kotelis; Werner H Mess; Michael J Jacobs

doi:10.1016/j.jvscit.2017.12.004

Recovery of lost motor evoked potentials in open thoracoabdominal aortic aneurysm repair using intercostal artery bypass

J Vasc Surg Cases Innov Tech. 2018 Feb 27;4(1):54-57. doi: 10.1016/j.jvscit.2017.12.004. eCollection 2018 Mar.

Authors

Alexander Gombert¹, Jochen Grommes¹, Danny Hilkman², Drosos Kotelis¹, Werner H Mess², Michael J Jacobs¹

Affiliations

¹ European Vascular Center Aachen-Maastricht, Department of Vascular Surgery, University Hospital RWTH Aachen, Aachen, Germany.
² Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands.

Abstract

Ischemia of the spinal cord remains a disastrous complication in thoracoabdominal aortic aneurysm (TAAA) surgery. We report a case of open type I TAAA repair during which no motor evoked potentials were detectable for >1 hour after aortic cross-clamping. The creation of three intercostal artery bypasses restored spinal cord perfusion. As the patient showed only moderate clinical signs of spinal cord ischemia afterward, we underline the role of neuromonitoring to guide intercostal artery bypass implantation during TAAA surgery as the combined use of neuromonitoring and intercostal artery bypass implantation may prevent paraplegia in specific TAAA cases.

Publication types

Case Reports