PuSH - Publikationsserver des Helmholtz Zentrums München: Evaluation of spinal cor blood supply with hyperspectral imaging of the paraspinous musculature during staged endovascular repair of thoracoabdominal aortic aneurysm: A sub-study of the prospective multicenter PAPA-ARTiS trial.

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Winther, B. ; Branzan, D. ; Etz, C.D.* ; Geisler, A.A.* ; Steiner, S. ; Winther, H.* ; Meixner, R. ; Jiménez-Muñoz, M. ; Kohler, H.* ; Scheinert, D.* ; Schmidt, A.*

Evaluation of spinal cor blood supply with hyperspectral imaging of the paraspinous musculature during staged endovascular repair of thoracoabdominal aortic aneurysm: A sub-study of the prospective multicenter PAPA-ARTiS trial.

J. Clin. Med. 14:3188 (2025)

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Background/Objectives: Our aim was to assess the feasibility of hyperspectral imaging (HSI) to detect changes in tissue oxygenation (StO₂) of the back, as non-invasive spinal cord collateral network (CN) monitoring during staged endovascular repair (ER) of thoracoabdominal aortic aneurysm (TAAA). Methods: Between September 2019 and June 2021, 20 patients were treated for TAAA and underwent HSI. They were randomized 1:1 to minimally invasive staged segmental artery coil embolization (MIS2ACE) (n = 10) and staged stentgraft implantation (n = 10) as priming methods. HSI of paravertebral regions was taken during each procedure and up to 10 days after. The primary endpoint was the identification of StO₂ changes after ER of TAAA. Results: TAAA Crawford Type II (n = 17) and Type III (n = 3) were treated. After stentgrafting, StO₂ increased immediately (p < 0.001), followed by a decrease after 5 days (p < 0.001) and 10 days (p = 0.028). StO₂ was significantly higher in the thoracic compared to the lumbar region. There was no significant difference between MIS2ACE and the first stentgrafting for StO₂ (p = 0.491). Following MIS2ACE, definitive ER caused a significant decrease in StO₂ after 5 days (p = 0.021), which recovered to baseline after 10 days (p = 0.130). After stentgraft priming, definitive ER caused a significant decrease in StO₂ after 24 h (p = 0.008), which did not return to baseline after 5 (p < 0.001) and 10 days (p = 0.019). Conclusions: HSI detected significant changes in StO₂ in the thoracic and lumbar paravertebral regions during ER of TAAA. These preliminary data suggest the efficacy of MIS2ACE in priming the CN before ER of TAAA.

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