How we do it

A systematic approach to paraplegia risk in the surgical treatment of thora coabdominal aortic aneurysms based on effective strategies identified from the experimental literature is discussed. With this approach, collateral bl ood flow. rather than direct intercostal reimplantation, moderate hypotherm ia and endorphin receptor, is emphasized blockade, The result has been a 10 -fold reduction in paraplegia risk in elective patients and a 5-fold reduct ion in acute patients. This reduction in paralysis risk has resulted in imp roved short- and long-term survival. (C) 1999 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights rese rved.