About this Research Topic
Spinal cord injury (SCI) is a serious complication of both open and endovascular repair of descending thoracic and thoraco-abdominal aortic aneurysms. Though endovascular treatment has greatly evolved over the years and is currently applied to challenging anatomy, the incidence of permanent SCI has been reported to be between 2% and 10%.
SCI continues to be the most devastating complication occurring in up to 35% of patients. Permanent paraplegia has a paramount impact on the patient’s intensive care, hospital stay, mortality rate, quality of life, and long-term prognosis. Therefore, pre-operative, intra-operative, and post-operative strategies should be applied to reduce SCI as much as possible. SCI protection strategies can be categorized into two approaches: neuroprotective measures and optimization of spinal cord perfusion. Many of these, however, are yet to be studied in endovascular surgery and have predominantly been applied to open surgical reconstruction only. In addition to this, no randomized controlled trials have compared the incidence of SCI in open and endovascular aortic repairs.
Concerns have been raised about the risks of some of these strategies, emphasizing the need for careful patient selection. As such, defining which patients are most likely to benefit from these protective strategies is a topic of great interest.
What is more, when SCI develops after endovascular surgery, immediate recognition and broad action of any weakness or deficit is compelling. Rescue maneuvers must be immediately applied to limit as much as possible the damage, which may require emergent surgical intervention.
In this Research Topic, we welcome studies that focus on SCI protection strategies and/or optimization of these, spinal cord monitoring to avoid SCI, patient identification that would benefit from specific protection strategies the most, and rescue maneuvers, and/or optimization of these.
Original studies and reviews (including meta-analyses) are particularly welcomed.
SCI continues to be the most devastating complication occurring in up to 35% of patients. Permanent paraplegia has a paramount impact on the patient’s intensive care, hospital stay, mortality rate, quality of life, and long-term prognosis. Therefore, pre-operative, intra-operative, and post-operative strategies should be applied to reduce SCI as much as possible. SCI protection strategies can be categorized into two approaches: neuroprotective measures and optimization of spinal cord perfusion. Many of these, however, are yet to be studied in endovascular surgery and have predominantly been applied to open surgical reconstruction only. In addition to this, no randomized controlled trials have compared the incidence of SCI in open and endovascular aortic repairs.
Concerns have been raised about the risks of some of these strategies, emphasizing the need for careful patient selection. As such, defining which patients are most likely to benefit from these protective strategies is a topic of great interest.
What is more, when SCI develops after endovascular surgery, immediate recognition and broad action of any weakness or deficit is compelling. Rescue maneuvers must be immediately applied to limit as much as possible the damage, which may require emergent surgical intervention.
In this Research Topic, we welcome studies that focus on SCI protection strategies and/or optimization of these, spinal cord monitoring to avoid SCI, patient identification that would benefit from specific protection strategies the most, and rescue maneuvers, and/or optimization of these.
Original studies and reviews (including meta-analyses) are particularly welcomed.
Keywords: spinal cord injury, endovascular surgery, thoracoabdominal repair, evar, tevar, fevar, Bevar, aorta, aneurysm, spinal cord protection
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