{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:14:57Z","timestamp":1740136497855,"version":"3.37.3"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005633","name":"Finnish Foundation for Cardiovascular Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005633","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Oulu University Hospital"},{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9lius Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>\u2002<\/jats:title><\/jats:sec><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Since selective cerebral perfusion (SCP) has been used in aortic arch surgical procedures, the core temperature during lower body circulatory arrest (LBCA) has been steadily rising. Simultaneously, the use of a frozen elephant trunk (FET) graft has been increasing. The safe period of LBCA in relation to spinal cord ischaemic tolerance in combination with segmental artery occlusion by the FET procedure has not been defined.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Sixteen pigs were assigned to undergo 65 (n\u2009=\u200910) or 90\u2009min (n\u2009=\u20096) of SCP at 28\u00b0C with LBCA in combination with occlusion of the 8 uppermost segmental arteries in the thoracic (Th) aorta (15\u201320\u2009cm FET, Th8-level). The follow-up period consisted of a 6-h intensive period and a 5-day observation period. Near-infrared spectroscopy of the collateral network was used to determine spinal cord oxygenation. The neurological status of the patients was evaluated daily, and the brain and the spinal cord were harvested for a histopathological analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Five out of 6 pigs after 90\u2009min and 1 out of 10 pigs after 65 min of LBCA died within 48\u2009h of multiorgan failure. Of the survivors in the 65-min group, 6 out of 9 had paraparesis\/paraplegia; the remaining 3 reached normal function. The lone survivor after 90\u2009min of LBCA was paraplegic. Nadir near-infrared spectroscopy of the collateral network values at Th8 and Th10 were 34 (\u00b15) and 39 (\u00b14), and they were reached within 35\u2009min of SCP in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>An extended FET graft with LBCA and SCP durations &amp;gt;65\u2009min at 28\u00b0C results in a poor outcome.<\/jats:p><\/jats:sec>","DOI":"10.1093\/icvts\/ivab219","type":"journal-article","created":{"date-parts":[[2021,7,27]],"date-time":"2021-07-27T19:10:53Z","timestamp":1627413053000},"page":"145-152","source":"Crossref","is-referenced-by-count":2,"title":["Spinal cord injury during selective cerebral perfusion and segmental artery occlusion: an experimental study"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5861-4684","authenticated-orcid":false,"given":"Hannu-Pekka","family":"Honkanen","sequence":"first","affiliation":[{"name":"Department of Surgery, Research Unit of Surgery, 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