HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Kenji Okada Yutaka Okita Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kawanishi, Y. Articles by Okita, Y. Search for Related Content PubMed PubMed Citation Articles by Kawanishi, Y. Articles by Okita, Y.

J Thorac Cardiovasc Surg 2007;133:1553-1558
© 2007 The American Association for Thoracic Surgery

Cardiopulmonary Support and Physiology

The adverse effect of back-bleeding from lumbar arteries on spinal cord pathophysiology in a rabbit model

Division of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan.

Received for publication June 27, 2006; revisions received October 6, 2006; accepted for publication October 18, 2006.

^_* Address for reprints: Yutaka Okita, 7-5-2, Kusunoki-Cho, Chuo-Ku, Kobe City, Hyogo, Japan. (Email: yokita{at}med.kobe-u.ac.jp).

Objective: The purpose of this study was to evaluate the adverse effect of back-bleeding from the lumbar arteries on spinal cord pathophysiology in a rabbit model.

Methods: White rabbits were divided into 3 groups. Through laparotomy, the abdominal aorta was clamped below the renal artery and above the aortic bifurcation for 15 minutes. In group 1 (n = 13), back-bleeding from the lumbar arteries was drained from the aorta during aortic clamping. In group 2 (n = 10), back-bleeding was not drained. Group 3 (n = 6) was the sham-operated group. Postoperative hind limb function was evaluated using the modified Tarlov scale, and cell damage was analyzed by counting the number of intact motor neurons and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL)-positive neurons.

Results: At 4 hours after operation, all animals were neurologically impaired in group 1 and normal in group 2. Motor neurons were significantly damaged in group 1 compared with groups 2 and 3 (P < .05). Forty-eight hours later, almost all animals were neurologically and pathologically damaged in groups 1 and 2. There was no difference in the number of normal motor neurons between the two groups, but the number of TUNEL-positive cells in group 2 was significantly larger than those in group 1.

Conclusions: Rabbits with 15-minute aortic clamping in the infrarenal portion showed delayed paraplegia, and those with back-bleeding from lumbar arteries showed early onset of paraplegia. The prevention of back-bleeding from intercostal arteries and lumbar arteries during thoracoabdominal aortic surgery was considered to reduce spinal ischemic injury.