Prevention of spinal cord injury during endovascular thoracoabdominal repair.

Spinal cord injury is the most devastating complication after aortic surgery. Rates of spinal cord injury vary from 0% up to 40%. Predictive factors include extent of coverage, hypogastric artery occlusion, prior aortic repair and perioperative hypotension. This article summarizes current strategies that are utilized to minimize risk of spinal cord injury including use of cerebrospinal fluiddrainage, early limb reperfusion, staging and neuro-monitoring.