Establishing clinically relevant method of trans-esophageal motor evoked potential

2019 Fiscal Year Final Research Report

• Project/Area Number: 16K10656
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Cardiovascular surgery
• Research Institution: Hamamatsu University School of Medicine
• Principal Investigator: Shiiya Norihiko 浜松医科大学, 医学部, 教授 (00250449)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Keywords: 脊髄虚血 / 運動誘発電位

Outline of Final Research Achievements

Although trans-cranial motor evoked potential (TC-MEP) has been used to prevent ischemic spinal cord injury during aortic surgery, low specificity has been a problem. We have developed trans-esophageal motor evoked potential (TE-MEP) and have shown that it has a better specificity. As a clinically relevant method of TE-MEP, a novel method of bipolar trans-esophageal thoracic cord stimulation was developed, and its feasibility and utility were confirmed in an animal study. In a clinical study, TE-MEP can consistently be monitored after modification of a stimulation electrode and stimulation condition. Its specificity was better than that of TC-MEP. This result was presented at EACTS meeting in Lisbon (October 2019), and was published in EJCTS (doi:10.1093/ejcts/ezaa002).

Free Research Field

心臓血管外科

Academic Significance and Societal Importance of the Research Achievements

大動脈外科手術に伴う虚血性脊髄障害は、生活の質のみならず生命予後をも不良とし、国家医療費の増大と患者・家族の負担を強いる重篤な合併症である。TC-MEPは不安定性や特異性の低さから、十分に普及していないが、TE-MEPにより、これらTC-MEPの問題点が解決されれば、大動脈外科手術中モニタリングの普及を通し、虚血性脊髄障害発生率低下に貢献することが出来る。