Extensive spinal cord ischemia following endovascular repair of an infrarenal abdominal aortic aneurysm: a rare complication

Abstract

Postoperative paraplegia secondary to spinal cord ischemia (SCI) is an extremely rare and devastating complication of endovascular repair in abdominal aortic aneurysm (AAA) surgery. The reported incidence is only 0.21 % worldwide. This case of postoperative paraplegia occurred in a 60-year-old man immediately following endovascular repair of an infrarenal AAA. Postoperative magnetic resonance imaging showed multiple foci of SCI involvement from C5 to L1. However, neither cerebral spinal fluid drainage nor steroid therapy was effective; he was eventually admitted with no improvement in his neurological status. The mechanism remains multifactorial until now and needs more attention in perioperative management. We report the first case involved in the most significantly extensive SCI after endovascular repair of an infrarenal AAA.

Intramedullary spinal tumor-like lesions

“…Acute spinal cord ischemia can also be seen as a complication of aortic aneurysm surgery or stenting and has been reported with an incidence of 0.25-0.3% (41). The following factors may cause spinal cord ischemia in this situation: prolonged suprarenal clamping, hypotension, thromboembolism, or occlusion of the radicular artery of Adamkiewicz (42).…”