Endovascular repair and open repair surgery of thoraco-abdominal aortic aneurysms cause drastically different types of spinal cord injury
Abstract Both endovascular repair (EVR) and open repair (OR) surgery of thoraco-abdominal aortic aneurysms cause spinal cord (SC) injury that can lead to paraparesis or paraplegia. It has been assumed that mechanisms responsible for SC damage after EVR are similar to those after OR. This pilot study...
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Nature Portfolio
2021
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oai:doaj.org-article:6193119cbed04fe0af4761d2f0c2327a2021-12-02T14:37:15ZEndovascular repair and open repair surgery of thoraco-abdominal aortic aneurysms cause drastically different types of spinal cord injury10.1038/s41598-021-87324-62045-2322https://doaj.org/article/6193119cbed04fe0af4761d2f0c2327a2021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-87324-6https://doaj.org/toc/2045-2322Abstract Both endovascular repair (EVR) and open repair (OR) surgery of thoraco-abdominal aortic aneurysms cause spinal cord (SC) injury that can lead to paraparesis or paraplegia. It has been assumed that mechanisms responsible for SC damage after EVR are similar to those after OR. This pilot study compared the pathophysiology of SC injury after EVR versus OR using a newly developed EVR dog model. An increasing number of stents similar to those used in patients were inserted in the aorta of three dogs to ensure thoracic or thoracic plus lumbar coverage. The aorta of OR dogs was cross-clamped for 45 min. Behavior assessment demonstrated unique patterns of proprioceptive ataxia and evolving paraparesis in EVR versus irreversible paraplegia in OR. MRI showed posterior signal in lumbar SC after EVR versus central cord edema after OR. Histopathology showed white matter edema in L3–L5 localized to the dorsal column medial lemniscus area associated with loss of myelin basic protein but not neurons after EVR, versus massive neuronal loss in the gray matter in L3–L5 after OR. Metabolome analysis demonstrates a distinctive chemical fingerprint of cellular processes in both interventions. Our results call for the development of new therapeutics tailored to these distinct pathophysiologic findings.Hamdy AwadEsmerina TiliGerard NuovoHesham KelaniMohamed Ehab RamadanJim WilliamsKatherine BinzelJayanth RajanDavid MastAlexander A. EfanovKareem B. RasulSarah MooreMichele BassoAdel MikhailMostafa EltobgyRaphael A. MalbrueEric BourekasMichael OglesbeeValerie BergdallMichael KnoppJean-Jacques MichailleHosam El-SayedNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-13 (2021) |
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Medicine R Science Q |
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Medicine R Science Q Hamdy Awad Esmerina Tili Gerard Nuovo Hesham Kelani Mohamed Ehab Ramadan Jim Williams Katherine Binzel Jayanth Rajan David Mast Alexander A. Efanov Kareem B. Rasul Sarah Moore Michele Basso Adel Mikhail Mostafa Eltobgy Raphael A. Malbrue Eric Bourekas Michael Oglesbee Valerie Bergdall Michael Knopp Jean-Jacques Michaille Hosam El-Sayed Endovascular repair and open repair surgery of thoraco-abdominal aortic aneurysms cause drastically different types of spinal cord injury |
| description |
Abstract Both endovascular repair (EVR) and open repair (OR) surgery of thoraco-abdominal aortic aneurysms cause spinal cord (SC) injury that can lead to paraparesis or paraplegia. It has been assumed that mechanisms responsible for SC damage after EVR are similar to those after OR. This pilot study compared the pathophysiology of SC injury after EVR versus OR using a newly developed EVR dog model. An increasing number of stents similar to those used in patients were inserted in the aorta of three dogs to ensure thoracic or thoracic plus lumbar coverage. The aorta of OR dogs was cross-clamped for 45 min. Behavior assessment demonstrated unique patterns of proprioceptive ataxia and evolving paraparesis in EVR versus irreversible paraplegia in OR. MRI showed posterior signal in lumbar SC after EVR versus central cord edema after OR. Histopathology showed white matter edema in L3–L5 localized to the dorsal column medial lemniscus area associated with loss of myelin basic protein but not neurons after EVR, versus massive neuronal loss in the gray matter in L3–L5 after OR. Metabolome analysis demonstrates a distinctive chemical fingerprint of cellular processes in both interventions. Our results call for the development of new therapeutics tailored to these distinct pathophysiologic findings. |
| format |
article |
| author |
Hamdy Awad Esmerina Tili Gerard Nuovo Hesham Kelani Mohamed Ehab Ramadan Jim Williams Katherine Binzel Jayanth Rajan David Mast Alexander A. Efanov Kareem B. Rasul Sarah Moore Michele Basso Adel Mikhail Mostafa Eltobgy Raphael A. Malbrue Eric Bourekas Michael Oglesbee Valerie Bergdall Michael Knopp Jean-Jacques Michaille Hosam El-Sayed |
| author_facet |
Hamdy Awad Esmerina Tili Gerard Nuovo Hesham Kelani Mohamed Ehab Ramadan Jim Williams Katherine Binzel Jayanth Rajan David Mast Alexander A. Efanov Kareem B. Rasul Sarah Moore Michele Basso Adel Mikhail Mostafa Eltobgy Raphael A. Malbrue Eric Bourekas Michael Oglesbee Valerie Bergdall Michael Knopp Jean-Jacques Michaille Hosam El-Sayed |
| author_sort |
Hamdy Awad |
| title |
Endovascular repair and open repair surgery of thoraco-abdominal aortic aneurysms cause drastically different types of spinal cord injury |
| title_short |
Endovascular repair and open repair surgery of thoraco-abdominal aortic aneurysms cause drastically different types of spinal cord injury |
| title_full |
Endovascular repair and open repair surgery of thoraco-abdominal aortic aneurysms cause drastically different types of spinal cord injury |
| title_fullStr |
Endovascular repair and open repair surgery of thoraco-abdominal aortic aneurysms cause drastically different types of spinal cord injury |
| title_full_unstemmed |
Endovascular repair and open repair surgery of thoraco-abdominal aortic aneurysms cause drastically different types of spinal cord injury |
| title_sort |
endovascular repair and open repair surgery of thoraco-abdominal aortic aneurysms cause drastically different types of spinal cord injury |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/6193119cbed04fe0af4761d2f0c2327a |
| work_keys_str_mv |
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