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Evoked Spinal Cord Potential (ESP) for Detection and Prevention of Spinal Cord Ischemia During Aortic Cross-Clamping.

Research Project

Project/Area Number 61480290
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field Thoracic surgery
Research InstitutionHokkaido University.

Principal Investigator

YASUDA Keishu (1987)  Hokkaido University Hospital. Associate Professor., 医学部附属病院, 助教授 (60125359)

松波 己 (1986)  北海道大学, 医学部, 助手 (70142726)

Co-Investigator(Kenkyū-buntansha) SAKUMA Makoto  Hokkaido University Hospital. Instructor., 医学部附属病院, 助手 (70170636)
橋本 正人  北海道大学, 医学部, 助教授 (70002269)
TANABE Tatsuzo  Hokkaido University, School of Medicine. Chief Professor., 医学部, 教授 (50000956)
安田 慶秀  , 医学部附属病院, 助教授 (60125359)
Project Period (FY) 1986 – 1987
Project Status Completed (Fiscal Year 1987)
Budget Amount *help
¥4,300,000 (Direct Cost: ¥4,300,000)
Fiscal Year 1987: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 1986: ¥3,300,000 (Direct Cost: ¥3,300,000)
KeywordsThoracic aortic aneurysm / Aortic cross-clamping / Evoked spinal cord potential / Somato-sensory evoked potential / ESP / SEP / Spinal cord ischemia / 胸部大動脈瘤 / 大動脈瘤
Research Abstract

Evoked spinal cord potential (ESP) was recorded and analyzed in order to detect and prevent the paraplegia caused by spinal cord ischemia during thoracic aortic cross-ciamping.
(1) Experiment.
Material and Methods: Adult dogs underwent continuous monitoring of ESP before, during, and after aortic cross-clamping. Stimulating electrodes were placed in the epidural space near L-1, sensing electrodes were placed in the intervertebral disc between T-3 and T-5. 5 to 100 responses were averaged to construct %e%sP..
Results: ESP responses to aortic cross-clamping were categorized into three types: loss of ESP during aortic cross-clamp (type 1),'no change in ESP during cross- clamp (type 2), and transient depression and return of ESP during cross-clamp (type 3). All dogs of type 1 response demonstrated paraplegia, where-as no dog of type 2 response showed paraplegia. Some dogs of type 3 response demonstrated spastic paraplegia. Although cross-clamp was removed 10 minutes after ESP became 20% of the previous amplitude in another series of type 1 dogs, paraplegia was not prevented.
Histological examination revealed infarction of the grey matter of the spinal cord below T-8 in the dogs with paraplegia.
Selective perfusion of the intercostal arteries furing cross-clamping and intraaortic infusion of vasodilators seemed promising to prevent spinal cord ischemic injury.
(2) Practice
ESP was monitored in 30 patients who underwent thoracic aortic surgery.
23 patients showed type 2 response. ESP was slightly depressed in 4 patients. 3 patients demonstrated type 1 response; temporary bypass was re-established in one case, cross-clamp could be released within a few minutes after ESP loss in other two cases. No paraplegia was experienced.
We have invented a special bypass tube to perfuse intercostal arteries during aortotomy in case of prolonged type 1 response which strongly suggests spinal cord ischemia.

Report

(2 results)
  • 1987 Final Research Report Summary
  • 1986 Annual Research Report

Research Products

(6 results)

All Other

All Publications (6 results)

  • [Publications] 松居喜郎, 郷一知,奥出潤, 佐久間まこと, 安田慶秀, 田辺達三: 日本胸部外科学会雑誌. 34. 38 (1986)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] 松虚喜郎: 日本外科学会雑誌. 87. 1344 (1985)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] Matsui,Yoshiro.: "Evoked spinal cord potential for detection of spinal cord ischemia during aortic cross-clamping. -Evoked spinal cord potential (ESP) vs. Somato-sensory evoked potential.-" The Journal of the Japanese Association for Thoracic Surgery.34. 38- (1986)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] Matsui,Yoshiro.: "Prevention of Spinal Cord Ischemia During Aortic Cross-clamping. -Evoked Spinal Cord Potential as a Monitor of Spinal Cord Ischemia.-" Journal of Japan Surgical Society. 87. 1344- (1985)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1987 Final Research Report Summary
  • [Publications] 松居喜郎,郷一知,奥出潤,佐久間まこと,安田慶秀,田辺達三: 日本胸部外科学会誌. 34. 172-179 (1986)

    • Related Report
      1986 Annual Research Report
  • [Publications] 松居喜郎: 日本外科学会雑誌. 87. 1344-1351 (1986)

    • Related Report
      1986 Annual Research Report

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Published: 1987-03-30   Modified: 2016-04-21  

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