Accuracy and Applicability of Motor Evoked Potential Monitoring during Open Thoraco-Abdominal Aortic…

StudyEuropean journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery· Jan 2026

Accuracy and Applicability of Motor Evoked Potential Monitoring during Open Thoraco-Abdominal Aortic Aneurysm Repair.

Jelle Frankort, Werner H Mess, Julia Krabbe … Michael J Jacobs

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Clinical NeurophysiologyStudyClinical practiceQ1IF 3.1

Absent motor evoked potential signals at the end of open thoraco-abdominal aortic aneurysm repair predicted acute spinal cord ischaemia in this case series.

Accuracy and Applicability of Motor Evoked Potential Monitoring during Open Thoraco-Abdominal Aortic Aneurysm Repair.

Jelle Frankort … Michael J Jacobs

European journal of vascular and endovascular surgery · Jan 2026

Purpose

The objective of this study was to evaluate the accuracy and clinical utility of motor evoked potential (motor evoked potential) monitoring in predicting and preventing spinal cord ischaemia during open thoraco-abdominal aortic aneurysm repair.

Methods

This retrospective case series study analysed 464 patients who underwent elective thoraco-abdominal aortic aneurysm repair with motor evoked potential monitoring across two academic referral centres between 2000 and 2024.

n = 464 patients

100%

Results

100%

Sensitivity of absent end-of-operation motor evoked potentials for acute spinal cord ischaemia; specificity and predictive values were also 100%.

n = 464 patients

More results

Clinically significant motor evoked potential changes occurred in 108 patients (23.3%), with recovery achieved in 99 cases (91.7%) following intra-operative measures to increase spinal cord perfusion.

All nine patients without motor evoked potential recovery developed acute paraplegia.

More results

Among 356 patients with stable MEPs, none developed acute spinal cord ischaemia, although 18 (5.1%) experienced delayed paraplegia associated with post-operative haemodynamic instability.

The acute spinal cord ischaemia rate was 1.9% (9 of 464), and any form of spinal cord ischaemia (acute, delayed, or uncertain) occurred in 7.7% of cases (36 of 464).

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Conclusion

Motor evoked potential monitoring is an excellent method, providing a proper execution and a compatible anaesthetic protocol, for detecting acute peri-operative spinal cord ischaemia and greatly influences decision making to prevent acute spinal cord ischaemia during open thoraco-abdominal aortic aneurysm procedures, although delayed spinal cord ischaemia remains an important factor that may not be detected by motor evoked potential changes alone, largely owing to factors occurring post-operatively.

Accuracy and Applicability of Motor Evoked Potential Monitoring during Open Thoraco-Abdominal Aortic Aneurysm Repair.

Accuracy and Applicability of Motor Evoked Potential Monitoring during Open Thoraco-Abdominal Aortic Aneurysm Repair.

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