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Reproducable Paraplegia by Thoracic Aortic Occlusion in a Murine Model of Spinal Cord Ischemia-reperfusion
Published on: March 3, 2014
Identifying paraplegia risk associated with thoracic endografting
Ourania Preventza1, Grayson H Wheatley, James Williams
1Department of Cardiovascular and Endovascular Surgery Arizona Heart Institute Phoenix, AZ, USA. opsmile01@aol.com
Asian Cardiovascular & Thoracic Annals
|December 23, 2009
Summary
Thoracic endografting can cause paraplegia, particularly in women with aneurysms requiring extensive aortic coverage. Early intervention with cerebrospinal fluid drainage may improve outcomes for spinal cord events.
Area of Science:
- Vascular Surgery
- Neurology
- Medical Device Technology
Background:
- Thoracic endografting is an alternative to open repair for descending thoracic aorta pathologies.
- Paraplegia is a known complication of both open and endovascular thoracic aortic repair.
Purpose of the Study:
- To review the incidence and treatment of spinal cord neurologic events after thoracic endografting.
- To identify risk factors associated with paraplegia following thoracic endovascular aortic repair.
Main Methods:
- Retrospective review of 346 patients undergoing thoracic endografting between February 2000 and July 2008.
- Analysis of indications for repair, patient demographics, extent of aortic coverage, and neurological outcomes.
- Evaluation of treatment strategies, including cerebrospinal fluid drainage.
Main Results:
- 4.0% of patients developed paraparesis or paraplegia.
- Risk factors included female sex, aneurysmal disease, and coverage of >20 cm of the thoracic aorta.
- Cerebrospinal fluid drainage was used in 7/8 paraplegic patients, with 57.1% achieving full recovery.
Conclusions:
- Paraplegia after thoracic endografting is associated with specific patient and procedural factors.
- Timely intervention, such as cerebrospinal fluid drainage, may improve neurological recovery.
- Further research is needed to refine preventative strategies and treatment protocols.
