Avidin and ¹¹¹In-labelled biotin scan: A new radioisotopic method for localising vascular graft infection

详细信息    查看全文

• 作者：Roberto Chiesa ; Germano Melissano ; Renata Castellano ; Cristina Fern ; ez Zamora ; Domenico Astore ; Anthony Samuel ; Giovanni Paganelli ; Ferruccio Fazio ; Adalberto Grossi
• 关键词：Vascular prostheses ; Arterial graft infection ; Avidin/Biotin scan
• 刊名：European Journal of Vascular and Endovascular Surgery
• 出版年：1995
• 出版时间：November 1995
• 年：1995
• 卷：10
• 期：4
• 页码：405-414
• 全文大小：7171 K

文摘

Since the publication of prior reviews on this topic, substantial clinical experience with a variety of operative strategies to prevent ischaemic cord complications has been reported. The available data on angiographic localisation of critical intercostal vessels, and, in particular, the evoked potential response to cross-clamping in patients indicates that risk of paraplegia varies considerably even among patients with equivalent TAA extent. Factors such as individual development of the ASA, patent critical intercostals, and the particulars of collateral circulation when intercostal aortic ostia are already occluded likely account for this variability. Information available from SSEP monitoring relative to the dynamic course of cord ischaemia with cross-clamping, and the parallel, if not, frustrating experience with angiographic localisation and intercostal vessel reconstruction indicates that a narrow temporal threshold of cord ischaemia with clamping is present in many patients. This reinforces the importance of both expeditious clamp intervals, critical intercostal re-anastamoses, and the desirability of neuroprotective manoeuvres during cross-clamp induced cord ischaemia. As suggested in compelling experimental work our contemporary clinical experience, and predicted by prior reviewers, regional cord hypothermia provides significant promise for limiting or eliminating, in particular, immediate perioperative deficits. Avoidance of postoperative hypotension, spinal cord oedema, and preservation of critical intercostal vessels are additional strategies necessary to impact the development of delayed deficits favourably.