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Surgical repair of long segments of the aorta (main systemic artery) carries the risk of paraplegia, paralysis in the lower part of the body. This paraplegia may be a consequence of lack of adequate blood supply to the spinal cord during surgery. The great radicular artery (GRA) is a major component of spinal cord circulation. There is considerable anatomic variation in the point cord may be altered by the development of vascular disease such as atherosclerosis (the presence of cholesterol plaque formation on the inner layer of the artery wall) and mural thrombus (clots along the wall of the artery). Various techniques have been developed to protect spinal cord circulation during aortic surgery, but these do not identify the origin of the blood supply to the spinal cord. A report is presented of 47 patients who underwent catheterization of the thoracic intercostal and lumbar arteries to attempt to identify the origin of spinal cord blood supply. The origin was identified in 26 patients (55 percent); 21 of these patients underwent aortic aneurysm repair. In 12 patients this artery could be included in the anastomosis (surgical connection of blood vessels); all 12 patients survived, one ended up paralyzed. In nine patients this was not able to be done and seven of the nine patients died or were paralyzed. Sixteen of the 19 patients in whom the blood supply was not able to be identified had successful surgery; 12 of these survived. It is concluded that selective intercostal angiography is safe and may add to our understanding of spinal cord complications of aortic aneurysm surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)