Neuromonitoring for descending thoracic and thoracoabdominal aortic aneurysm repair

Abstract

A forty-four-year-old female presented with an extent II thoracoabdominal aortic aneurysm (TAAA) and lower back pain. Computed tomography demonstrated contained rupture of the 10 cm infrarenal abdominal aorta. The proximal descending aorta (DTA) was 5.5 cm in diameter but the aortic segment T8 to T12 was 3 cm in diameter. Thus, staged repair of the TAAA was planned. The patient successfully underwent first-stage, extent IV TAAA repair, which includes replacement of the aorta from T12 proximally to right iliac and left common femoral distally with bypass to the visceral/renal arteries. There were no motor evoked potentials (MEPs) or somatosensory evoked potentials (SSEPs) changes. All the patent lumbar arteries were ligated. Her postoperative course was uneventful. After ten days of recovery, the patient was taken back to the operating room for the second stage, completion of the extent II TAAA repair.