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. 2020 Sep 25;13(3):335-338.
doi: 10.3400/avd.cr.20-00061.

Spinal Cord Ischemia Following Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm

Shingo Nakai  1 , Tetsuro Uchida  1 , Yoshinori Kuroda  1 , Atsushi Yamashita  1 , Eiichi Oba  1 , Kimihiro Kobayashi  1 , Tomonori Ochiai  1 , Mitsuaki Sadahiro  1
Affiliations

Spinal Cord Ischemia Following Endovascular Repair of Infrarenal Abdominal Aortic Aneurysm

Shingo Nakai et al. Ann Vasc Dis. .

Abstract

Spinal cord injury (SCI) following endovascular aortic repair (EVAR) for an abdominal aortic aneurysm (AAA) is a rare but serious complication. Case 1 presented with ruptured AAA and shock and underwent emergency EVAR. The patient developed incomplete paraplegia 2 days following EVAR. Case 2, diagnosed with impending rupture of AAA with extremely shaggy aorta, was treated with emergency EVAR. The patient was diagnosed with complete paraplegia soon after EVAR. Case 3 underwent elective EVAR and developed delayed paraplegia 2 weeks later. In EVAR, the etiology of SCI leading to paraplegia is often multifactorial. Surgeons must consider the possibility of SCI-induced paraplegia.

Keywords: EVAR; paraplegia; spinal cord ischemia.

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Conflict of interest statement

Disclosure StatementNone of the authors have any conflict of interests to declare.

Figures

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Fig. 1 (A) Preoperative computed tomography reveals a 51 mm serial left common iliac artery aneurysm from the abdominal aortic aneurysm and a retroperitoneal hematoma. (B) Preoperative contrast-enhanced computed tomography showing the Adamkiewicz artery originating at the L1–L2 level (white arrows). (C) Three-dimensional computed tomographic reconstruction: The Adamkiewicz artery is indicated by white arrow heads.
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Fig. 2 (A) Contrast-enhanced computed tomography images conducted 4 years before the current presentation. The aorta has very severe atherosclerotic changes and mobile plaques. (B) Preoperative three-dimensional computed tomography in Case 3 shows a 56 mm infrarenal abdominal aortic aneurysm, a 26 mm right internal iliac artery (IIA) aneurysm, and collateral supply from the left femoral artery to the distal end of the occluded left IIA (pink color).
See this image and copyright information in PMC

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