| Project/Area Number |
09671372
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | Yamanashi Medical University |
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Principal Investigator |
SHINDO Shunya (1999) Second Department of Surgery, Yamanashi Medical University, Associate Professor, 医学部, 講師 (50206322)
神谷 喜八郎 (1997-1998) 山梨医科大学, 医学部, 助教授 (90111509)
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| Co-Investigator(Kenkyū-buntansha) |
KOBAYASHI Masahiro Second Department of Surgery, Yamanashi Medical University, Research Associate, 医学部, 助手 (40252019)
進藤 俊哉 (遠藤 俊哉) 山梨医科大学, 医学部, 助手 (50206322)
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| Project Period (FY) |
1997 – 1999
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| Project Status |
Completed (Fiscal Year 1999)
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| Budget Amount *help |
¥3,700,000 (Direct Cost: ¥3,700,000)
Fiscal Year 1999: ¥1,400,000 (Direct Cost: ¥1,400,000)
Fiscal Year 1998: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 1997: ¥1,300,000 (Direct Cost: ¥1,300,000)
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| Keywords | SPINAL CORD ISCHEMIA / GREAT RADICULAR ARTERY / INTRAOPERATIVE MONITORING / FPC / F WAVE / ANTERIOR SPINAL ARTERY / PARAPLEGIA / ADAMKIEWICZ / FP complex / 誘発電位 / 筋電位 |
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| Research Abstract |
Since 1998, we investigated that chemical injection (ex. KC1) to the lumbar artery was useful or not to identify the GRA with FPC. We concluded that this method for identification was impossible because a catheter which was introduced in the abdominal aorta caused FPC change due to spinal cord ischemia.
Now, we are proceeding chronic experimental study using rabbits to detect spinal cord ischemia by the ligation of 4 lumbar arteries. The infra renal lumbar arteries were exposed by left extraperioneal approach, then the most cranial one that is not related to the GRA was ligated. We selected 3 consecutive arteries and observed the change of FPC by clampping the arteries. When we observed depression of the wave, central 1 among 3 was preserved and other all 3 arteries were ligated (7 cases, group A ). When we observed no chage, these 3 arteries were ligated (5 cases, group B). The postoperative paraplegia was examined in the 2nd. post operative day. As a control experiment, 3 arteries were ligated when depression of the wave was observed (5 cases, group C). Paraplegia was observed in 4 of 5 cases in the 2nd. postoperative day in group C. Whereas no neurological deficit was observed in each group A or B.
We performed selective arteriography from remaining lumbar artery and investigated relations with the GRA in the 2nd. post operative day or later. As a result, we could observe that the GRA and anterior spinal artery were preserved by collateral circulation' and paraplegia could be evaded by these blood flow.
In conclusion, this method, preservation of one lumbar artery whether/it is GRA or not, is useful to evade paraplegia in the thoracoabdominal aoritc aneurysm surgery.
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