The impact of preoperative identification of the Adamkiewicz artery on descending and thoracoabdominal aortic repair

The Journal of Thoracic and Cardiovascular Surgery
Hiroshi TanakaJapanese Study of Spinal Cord Protection in Descending and Thoracoabdominal Aortic Repair investigators

Abstract

To investigate the impact of preoperative identification of the Adamkiewicz artery (AKA) on prevention of spinal cord injury (SCI) through the multicenter Japanese Study of Spinal Cord Protection in Descending and Thoracoabdominal Aortic Repair (JASPAR) registry. Between January 2000 and October 2011, 2435 descending/thoracoabdominal aortic repairs were performed, including 1998 elective repairs and 437 urgent repairs, in 14 major centers in Japan. The mean patient age was 67 ± 13 years, and 74.2% were males. There were 1471 open repairs (ORs), including 748 descending and 137 thoracoabdominal extent [Ex] I, 136 Ex II, 194 Ex III, 115 Ex IV, and 138 Ex V, and 964 endovascular repairs (EVRs). Of the 2435 patients, 1252 (51%) underwent preoperative magnetic resonance or computed tomography angiography to identify the AKA. The AKA was identified in 1096 of the 1252 patients who underwent preoperative imaging (87.6%). Hospital mortality was 9.2% (n = 136) in those who underwent OR and 6.4% (n = 62) in those who underwent EVR. The incidence of SCI was 7.3% in the OR group (descending, 4.2%; Ex I, 9.4%; Ex II, 14.0%; Ex III, 14.4%; Ex IV, 4.2 %; Ex V, 7.2%) and 2.9% in the EVR group. The risk factors for SCI in ORs were advanced age,...Continue Reading

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Citations

Aug 24, 2016·The Annals of Thoracic Surgery·Shingo TakaharaYoshikatsu Saiki
Oct 19, 2016·The Journal of Thoracic and Cardiovascular Surgery·Keisuke KandaYoshikatsu Saiki
Apr 6, 2018·General Thoracic and Cardiovascular Surgery·Akiko TanakaAnthony L Estrera
Nov 21, 2017·Interactive Cardiovascular and Thoracic Surgery·Atsushi OmuraJunjiro Kobayashi
Jan 26, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Kunihiro YoshiokaJoanne D Schuijf
Mar 22, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Toshiki FujiyoshiHitoshi Ogino
Oct 21, 2019·Journal of Anesthesia·Masahiko KawaguchiUNKNOWN MEP Monitoring Guideline Working Group of the Safety Committee of the Japanese Society of Anesthesiologists (JSA)
Jul 7, 2018·Journal of Thoracic Imaging·Daniel B GreenChristopher Lau
Nov 22, 2019·General Thoracic and Cardiovascular Surgery·Kyokun UeharaJunjiro Kobayashi
Sep 16, 2017·AJNR. American Journal of Neuroradiology·S ShimoyamaK Sugimura
Oct 31, 2017·Neuroradiology·Kunihiro YoshiokaYasuo Saito
Apr 29, 2019·Neuroradiology·Dominik TaterraBrandon Michael Henry
Feb 1, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Naomi YasudaNobuyoshi Kawaharada
Mar 25, 2021·Aorta : Official Journal of the Aortic Institute at Yale-New Haven Hospital·Toshihiro FukuiKen Okamoto
Apr 13, 2020·The Thoracic and Cardiovascular Surgeon·Takashi KuniharaHans-Jaochim Schäfers

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