PAPAartis – A clinical study to reduce complications in aortic surgery
Patients with an extensive enlargement of the aorta (one of the body’s major blood vessels), called thoracoabdominal aortic aneurysm (TAAA), are at high risk of bleeding to death if the aneurysm remains untreated and ruptures.
For the surgical treatment of those aneurysms, surgeons can rely on well-established procedures such as the use of stents or vascular prostheses.
However, as with all medical procedures, there are possible complications. Branches of the aorta supply the spinal cord directly with blood. During surgery, however, doctors have to interrupt the blood supply to the spinal cord in the diseased section of the aorta permanently. The lack of blood supply can damage the spinal cord. Under certain circumstances this can lead to spinal cord injuries – paraparesis or paraplegia. Currently, these severe outcomes affect about 10-20% of patients undergoing aneurysm repair for TAAA.
MISACE – Minimally invasive segmental embolisation of arterial coils.
After years of research, Prof. Christian D. Etz from the University of Leipzig has developed an innovative method that aims precisely at avoiding such fatal consequences. Three to five weeks before the operation, the physicians insert tiny coils of wire into the outgoing arteries of the spinal cord. The body reacts flexibly to this “manually induced” embolization. It forms new bypass circuits, which later ensure sufficient blood supply to the spinal cord during the surgical intervention. This is possible, even if the direct blood flow from the aorta is interrupted.
As part of the EU-funded PAPA-artis RCT-study, heart specialists at 33 locations in Europe and the USA are now testing this new method.
Spinal liquor drainage – pressure monitoring with LiquoGuard® 7
In aortic surgery, lumbar CSF drainage has also been shown to have a preventive effect on the development of paraplegia. The draining of cerebrospinal fluid reduces the pressure in the spinal cord. More and more aortic specialists, including those researching within PAPAartis, are using LiquoGuard® 7 due to its extended functionality. Especially the continuous drainage and the controlled monitoring lead to a more physiological and safer drainage and make the LiquoGuard® 7 the best choice.
Note: This article is based on information from the following pages.