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Prediction and treatment of delayed paraplegia after thoracic endovascular aortic repair

Research Project

Project/Area Number 26462108
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Cardiovascular surgery
Research InstitutionDepartment of Clinical Research, National Hospital Organization Kure Medical Center (2015-2016)
Hiroshima University (2014)

Principal Investigator

Takasaki Taiichi  独立行政法人国立病院機構(呉医療センター臨床研究部), その他部局等, 医師 (10383564)

Co-Investigator(Kenkyū-buntansha) 末田 泰二郎  広島大学, 医歯薬保健学研究院(医), 教授 (10162835)
高橋 信也  広島大学, 病院(医), 病院助教 (70423382)
Project Period (FY) 2014-04-01 – 2017-03-31
Project Status Completed (Fiscal Year 2016)
Budget Amount *help
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2016: ¥130,000 (Direct Cost: ¥100,000、Indirect Cost: ¥30,000)
Fiscal Year 2015: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2014: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
Keywords脊髄虚血 / 遅発性対麻痺 / 胸部大動脈瘤 / 胸腹部大動脈瘤 / ステントグラフト / 脊髄誘発電位 / ウサギ脊髄虚血モデル / 分節別遮断 / 対麻痺 / 脊髄前根動脈 / 脊髄虚血マーカー
Outline of Final Research Achievements

1) Comparative study using two rabbit models was performed to establish a new paraplegia model by ligating AKA and to investigate the mechanism of collateral circulation development. MEP decreasing just after clamping the aorta was associated with immediate postoperative paraplegia, however, delayed paraplegia did not occur in any rabbits.
2) Mechanism of postoperative delayed paraplegia was investigated in clinical cases. Thoracic endovascular aortic repair (TEVAR) was performed in 245 cases and 11 cases developed paraplegia. MEP monitoring was performed in 69 of 245 cases and 7 of 69 cases developed paraplegia, and the incidence of paraplegia in cases with MEP was significantly higher than without (7/69 vs 4/132, p=0.03). Lowest mean arterial pressure less than 55mmHg and stentgraft placement under than Th9 level were independent predictors of MEP decreasing. However, MEP decreasing did not predict the occurrence of delayed paraplegia.

Report

(4 results)
  • 2016 Annual Research Report   Final Research Report ( PDF )
  • 2015 Research-status Report
  • 2014 Research-status Report
  • Research Products

    (8 results)

All 2017 2015 2014

All Journal Article (8 results) (of which Peer Reviewed: 8 results,  Open Access: 6 results)

  • [Journal Article] Prevention of Spinal Cord Ischemia During Thoracic Endovascular Aortic Repair.2017

    • Author(s)
      Takahashi S, Sueda T
    • Journal Title

      Kyobu Geka

      Volume: 70 Pages: 251256-251256

    • NAID

      40021150389

    • Related Report
      2016 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Invited commentary2017

    • Author(s)
      Takahashi S
    • Journal Title

      Ann Thorac Surg

      Volume: 103 Issue: 3 Pages: 811-811

    • DOI

      10.1016/j.athoracsur.2016.07.034

    • Related Report
      2016 Annual Research Report
    • Peer Reviewed
  • [Journal Article] A successful hybrid repair for vertebral arteriovenous fistular with extracranial vertebral artery aneurysm2015

    • Author(s)
      Takahashi S, Katayama K, Tatsugawa T, Sueda T
    • Journal Title

      Ann Vas Surg

      Volume: 29 Pages: 5-8

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Prestenotic and post stenotic multiple aneurysms with adult coarctation2014

    • Author(s)
      Katayama K, Uchida N, Takasaki T, Sueda T
    • Journal Title

      J Vasc Surg

      Volume: 60 Pages: 234-235

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Multiple factors predict the risk of spinal cord injury after the frozen elephant trunk technique for extended thoracic aortic disease.2014

    • Author(s)
      Katayama K, Uchida N, Katayama A, Takahashi S, Takasaki T, Kurosaki T, Imai K, Sueda T
    • Journal Title

      Eur J Cardiothorac Surg

      Volume: 47 Issue: 4 Pages: 616-620

    • DOI

      10.1093/ejcts/ezu243

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Delayed surgery for type A aortic dissection caused by blunt trauma2014

    • Author(s)
      Takahashi S, Uchida N, Takasaki T, Sueda T
    • Journal Title

      Asian Cardiovasc Thorac Ann

      Volume: 23 Pages: 206-208

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Transintercostal-evoked spinal cord potential in thoracic aortic surgery2014

    • Author(s)
      Takahashi S, Orihahsi K, Imai K, Mizukami T, Takasaki T, Sueda T
    • Journal Title

      Ann Vasc Surg

      Volume: 28 Pages: 1775-1781

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Trehalose protects agianst spinal cord ischemia in rabbits2014

    • Author(s)
      Takahashi S, Isaka M, Hamamoto M, Orihahsi K, Sueda T
    • Journal Title

      J Vasc Surg

      Volume: 60 Pages: 490-496

    • Related Report
      2014 Research-status Report
    • Peer Reviewed / Open Access

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Published: 2014-04-04   Modified: 2018-03-22  

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