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Updated: May 11, 2026

Real-Time Assessment of Spinal Cord Microperfusion in a Porcine Model of Ischemia/Reperfusion
10:27

Real-Time Assessment of Spinal Cord Microperfusion in a Porcine Model of Ischemia/Reperfusion

Published on: December 10, 2020

Spinal cord ischemia after thoracic stent-grafting: causes apart from intercostal artery coverage

Burkhart Zipfel1, Semih Buz, Mathias Redlin

  • 1Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Berlin, Germany. zipfel@dhzb.de

The Annals of Thoracic Surgery
|May 16, 2013
PubMed

Insights

Spinal cord ischemia (SCI) after thoracic endovascular repair occurred in 2.7% of patients. Risk factors include prior aortic repair and extensive thoracic aorta coverage, but other individual factors also contribute to SCI.

Area of Science:

  • Vascular Surgery
  • Cardiovascular Research
  • Neurosurgery

Background:

  • Spinal cord ischemia (SCI) is a potential complication of thoracic endovascular repair (TEVAR).
  • Understanding SCI mechanisms and prevention is crucial for improving patient outcomes.
  • Large collective and individual case analyses can offer new insights into SCI after TEVAR.

Purpose of the Study:

  • To investigate the incidence, risk factors, and potential contributing elements of spinal cord ischemia (SCI) following thoracic endovascular repair (TEVAR).
  • To analyze the relationship between extensive aortic coverage and SCI.
  • To identify individual patient factors associated with SCI after TEVAR.

Main Methods:

  • Retrospective analysis of 406 patients undergoing TEVAR over an 11-year period.
  • Data collected included patient demographics, aortic pathology, stent-graft characteristics, and SCI incidence.
  • Statistical correlation analysis was performed to identify risk factors for SCI.

Main Results:

  • The overall incidence of SCI was 2.7%, with 1.5% experiencing major permanent deficits.
  • Significant risk factors for SCI included prior aortic repair (OR, 4.8), coverage of the entire descending thoracic aorta (OR, 3.6), and thoracoabdominal stent-graft implantation (OR, 9.5).
  • Individual factors like embolization, visceral ischemia, shock, and heparin-induced thrombocytopenia were also implicated.

Conclusions:

  • The incidence of SCI after TEVAR in this cohort was lower than anticipated, despite extensive intercostal artery sacrifice.
  • Extended coverage of the thoracic and thoracoabdominal aorta is associated with increased SCI risk.
  • Individual patient factors play a significant role in the occurrence of SCI after TEVAR.
Abstract

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