PMID- 8201705
OWN - NLM
STAT- MEDLINE
DCOM- 19940707
LR  - 20190821
IS  - 0741-5214 (Print)
IS  - 0741-5214 (Linking)
VI  - 19
IP  - 6
DP  - 1994 Jun
TI  - Prevention of paraplegia during thoracic aortic cross-clamping: importance of 
      patent internal mammary arteries.
PG  - 1044-51
AB  - PURPOSE: Unexplained anatomic and physiologic factors account for the 
      unacceptably high rate of paraplegia/paresis after thoracoabdominal aortic 
      reconstruction. We assessed the neurologic significance of patent internal 
      mammary arteries (IMAs) in a novel rat model of aortic clamping in which the 
      aortic origins of the intercostal arteries (ICAs) were occluded. METHODS: Twenty 
      anesthetized, intubated, and halothane-ventilated adult male rats had catheters 
      placed in the carotid and femoral arteries. ICAs arising from the aorta were 
      divided at their origins through a left thoracotomy. IMAs were either divided 
      (IMA-OUT, n = 10) or left intact (IMA-IN, n = 10). Proximal and distal descending 
      aortic clamps were placed for 7 minutes. A neurologic deficit score (NDS) was 
      assigned at 1, 4, 18, 24, and 48 hours by use of an established scoring system. 
      RESULTS: The mean IMA-IN NDS was statistically better than the mean IMA-OUT NDS 
      at 1, 4, 18, and 24 hours with p = 0.0005, 0.0014, 0.0098, and 0.0151, 
      respectively. Moreover, the mortality rate in the IMA-OUT group was statistically 
      greater than in the IMA-IN group (p = 0.0036). CONCLUSION: In this model, patent 
      IMAs prevent paraplegia when the ICAs are occluded at their aortic origin and the 
      aorta is clamped for 7 minutes.
FAU - Giglia, J S
AU  - Giglia JS
AD  - Department of Surgery, University of Michigan Medical School, Ann Arbor 
      48109-0622.
FAU - Zelenock, G B
AU  - Zelenock GB
FAU - D'Alecy, L
AU  - D'Alecy L
LA  - eng
GR  - IF32 HL08769-01/HL/NHLBI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
MH  - Animals
MH  - Aorta, Thoracic/*surgery
MH  - Constriction
MH  - Disease Models, Animal
MH  - Hemodynamics
MH  - Intraoperative Complications/physiopathology/*prevention & control
MH  - Male
MH  - Mammary Arteries/*physiology
MH  - Paraplegia/physiopathology/*prevention & control
MH  - Rats
MH  - Rats, Sprague-Dawley
MH  - Thoracic Arteries/physiology/surgery
MH  - Time Factors
MH  - *Vascular Patency
EDAT- 1994/06/01 00:00
MHDA- 1994/06/01 00:01
CRDT- 1994/06/01 00:00
PHST- 1994/06/01 00:00 [pubmed]
PHST- 1994/06/01 00:01 [medline]
PHST- 1994/06/01 00:00 [entrez]
AID - S0741521494003150 [pii]
AID - 10.1016/s0741-5214(94)70216-0 [doi]
PST - ppublish
SO  - J Vasc Surg. 1994 Jun;19(6):1044-51. doi: 10.1016/s0741-5214(94)70216-0.