Paraplegia Following Thoracic Endovascular Aneurysm Repair

Spinal cord ischemia is a rare but severe complication of thoracic endovascular aortic repair (TEVAR). Prompt diagnosis and cerebrospinal fluid (CSF) drainage are critical for neurologic recovery.

A 58-year-old man with a fusiform aneurysm in the descending thoracic aorta underwent TEVAR. Despite stable hemodynamics, he developed complete paraplegia and loss of bowel/bladder control post-TEVAR. Magnetic resonance imaging revealed an anterior spinal artery territory infarct. Therapeutic CSF drainage was initiated within 24 hours, resulting in a gradual neurologic improvement. At 3-month follow-up, the patient regained partial motor function and continence.

This case underscores the importance of early recognition and intervention in spinal cord ischemia following thoracic endovascular aortic repair. Timely CSF drainage can result in significant neurologic recovery, even in patients presenting with complete motor deficits.

This case highlights the critical importance of vigilant postoperative monitoring and timely intervention in preventing permanent deficits following TEVAR.