Neurophysiologic intraoperative monitoring during endovascular stent graft repair of the descending thoracic aorta.

Conventional surgery on the descending thoracic aorta for aneurysm or dissection repair typically involves open thoracotomy and cross-clamping of the aorta. These procedures are associated with the potential for significant neurologic morbidity due to spinal cord ischemia. Endovascular stent graft (EVSG) repair of the descending thoracic aorta precludes the need for aortic cross-clamping and appears to be associated with fewer neurologic complications. Several studies have demonstrated the utility of neurophysiologic intraoperative monitoring (NIOM) during conventional aortic surgery; however, less information is available regarding NIOM during EVSG repair. This paper reviews the data available regarding NIOM in EVSG repair of the descending thoracic aorta.