A Systematic Review of the Use of Biochemical Markers in the Assessment of Spinal Cord Ischemia in Thoracoabdominal Aortic Aneurysm Repair
| Autor: | Masafumi Muratani, Michael Jenkins, Andrew M.T.L. Choong, Ferenc Kovari, Ian Wee, Mark H. Almond, Rita Russai |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging Blood Vessel Prosthesis Implantation Young Adult 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors medicine Humans Biochemical markers Aged Aged 80 and over Aortic aneurysm repair Aortic Aneurysm Thoracic Spinal Cord Ischemia business.industry Endovascular Procedures Reproducibility of Results Spinal cord ischemia General Medicine Perioperative Middle Aged Surgery Treatment Outcome Regional Blood Flow Female Cardiology and Cardiovascular Medicine Complication business Biomarkers |
| Zdroj: | Vascular and Endovascular Surgery. 53:230-241 |
| ISSN: | 1938-9116 1538-5744 |
| Popis: | Introduction: Despite advances in perioperative critical care and surgical technique, spinal cord ischemia remains a devastating complication of thoracic and thoracoabdominal aortic aneurysm repair. Biochemical markers present in peripheral blood and cerebrospinal fluid (CSF) may be useful in assessing spinal cord injury. We systematically analyze and report the role of all reported biochemical markers that have been used in assessing and diagnosing spinal cord ischemia in thoracic and thoracoabdominal aortic aneurysm repair. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used for this review. Published literature was searched to identify all studies reporting on the use of biochemical markers in thoracoabdominal aortic aneurysm repair in the assessment of spinal cord ischemia. Marker-specific and patient-specific data were extracted from all studies and where possible, subgroup analysis was performed on marker-specific data sets. Results: Fourteen studies of 321 patients undergoing thoracic and thoracoabdominal aortic aneurysm repair were eligible for further analysis. Seven distinct biochemical markers were used in both CSF and blood samples: S100B proteins (S100B), neurone-specific enolase, lactate dehydrogenase, glial fibrillary acidic protein (GFAp), neurofilament triplet protein (NFL) and Tau protein, and glucose. There was substantial evidence demonstrating the heightened levels of S100, NFL, and GFAp in CSF in patients with spinal cord ischemia. There is however, wide variability in the correlation of the same 6 biochemical markers in peripheral blood and spinal cord ischemia. Conclusions: In patients with spinal cord injury, dramatic rises occur with S100B, NFL, and GFAp in CSF. However, further work is needed if biochemical markers are to impact on the future of thoracoabdominal aortic aneurysm repair. |
| Databáze: | OpenAIRE |
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