Elective sac perfusion to reduce the risk of neurologic events following endovascular repair of thoracoabdominal aneurysms
2012
Spinal cord ischemia (SCI) is a catastrophic complication of thoracoabdominal aortic aneurysm (TAAA) repair. This article describes our early experience with a technique for maintaining
perfusionof segmental vessels (intercostals and lumbars) in the early postoperative period after endovascular repair of a TAAA, with "sac
perfusionbranches" added to custom-made stent grafts. These are closed 7 to 10 days after the first procedure to complete exclusion of the aneurysm. We have used this technique in 10 patients with type II TAAAs. One developed monoparesis of the right leg during a period of hypotension secondary to a cardiac event and died within 30 days. Two patients developed lower limb weakness after closure of the
perfusionbranches, both with full recovery. Controlled
perfusionof segmental vessels with
perfusionbranches is feasible and may be a useful adjunct to prevent SCI, providing protection to spinal cord
perfusionduring the immediate postoperative period when risk of SCI is greatest.
Keywords:
-
Correction
-
Source
-
Cite
-
Save
8
References
40
Citations
NaN
KQI