Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2012;4(3):182-6.

Successful reversal of recurrent spinal cord ischemia following endovascular repair of a descending thoracic aortic aneurysm

J J Appoo  1 , H D Gregory, H D Toeg, C A Prusinkiewicz, W D T Kent, A Ferland, D V Ha
Affiliations
Case Reports

Successful reversal of recurrent spinal cord ischemia following endovascular repair of a descending thoracic aortic aneurysm

J J Appoo et al. HSR Proc Intensive Care Cardiovasc Anesth. 2012.

Abstract

Despite recent advances in technique, spinal cord ischemia remains one of the most dreaded complications of thoracic aortic surgery. Recently, it has been suggested that thoracic endovascular aortic repair may decrease the risk of paraplegia. We present a case of delayed paraplegia following thoracic endovascular aortic repair that was successfully reversed on 3 separate occasions in the same patient. This highlights the importance of vigilant clinical assessments, efficient multidisciplinary teamwork, and maintenance of the determinants of spinal cord perfusion following endovascular thoracic aortic intervention.

Keywords: anesthesia; aneurysm; endovascular aortic repair; spinal cord ischemia; spinal cord paraplegia; vascular surgery.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest None declared.

Figures

Figure 1
Figure 1
Pre-operative thoracoabdominal contrast enhanced computed tomography scan (computer 3D rendered) demonstrating oxbow shaped anuerysm extending from T8 to L2.
Figure 2
Figure 2
Post-op 3D-computed tomography scan image illustrating good stent graft coverage & patent visceral bypass grafts from left iliac artery.
See this image and copyright information in PMC

References

    1. Setacci F, Sirignano P, De Donato G. et al. Endovascular thoracic aortic repair and risk of spinal cord ischemia: the role of previous or concomitant treatment for aortic aneurysm. J Cardiovasc Surg 2010; 51: 169-76. 2010;51:169–176. - PubMed
    1. Bavaria J E, Appoo J J, Makaroun M S. et al. Endovascular stent grafting versus open surgical repair of descending thoracic aortic aneurysms in low-risk patients: a multicenter comparative trial. J Thorac Cardiovasc Surg. 2007;133:369–377. - PubMed
    1. Estrera A L, Miller CC 3rd C C, Huynh T T. et al. Preoperative and operative predictors of delayed neurologic deficit following repair of thoracoabdominal aortic aneurysm. J Thorac Cardiovasc Surg. 2003;126:1288–1294. - PubMed
    1. Cheung A T, Pochettino A, McGarvey M L. et al. Strategies to manage paraplegia risk after endovascular stent repair of descending thoracic aortic aneurysms. Ann Thorac Surgery. 2005;80:1280–1288. - PubMed
    1. Buth J, Harris P L, Hobo R. et al. Neurologic complications associated with endovascular repair of thoracic aortic pathology: incidence and risk factors. A study from the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) Registry. J Vasc Surgery. 2007;46:1103–1111. - PubMed

Publication types

LinkOut - more resources