Late-Onset Paraplegia After Endovascular Repair of Type B Aortic Dissection Managed by Urgent Left Subclavian Artery Revascularization: A Case Report

Spinal cord ischemia is one of the most unpredictable and feared complications after open surgical or endovascular thoracic aortic repair. Protection of collateral network branches that contribute blood supply to spinal cord is fundamental in the prevention of this catastrophic condition. We report...

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Bibliographic Details
Published in:Annals of Vascular Surgery
Main Authors: Ottavia Borghese, Giorgio Sbenaglia, Rocco Giudice
Other Authors: Borghese, Ottavia, Sbenaglia, Giorgio, Giudice, Rocco
Format: Article in Journal/Newspaper
Language:English
Published: 2019
Subjects:
Spinal cord ischemia
arctic surgery
cerebrospinal fluid drainage
complication
Arctic
Online Access:https://hdl.handle.net/11573/1670379
https://doi.org/10.1016/j.avsg.2018.11.032
Description
Summary:Spinal cord ischemia is one of the most unpredictable and feared complications after open surgical or endovascular thoracic aortic repair. Protection of collateral network branches that contribute blood supply to spinal cord is fundamental in the prevention of this catastrophic condition. We report the case of a patient who underwent emergent endovascular treatment for a type B aortic dissection complicated by rupture of the false lumen, with intentional coverage of the left subclavian artery without revascularization. The patient developed paraplegia on the 10th postoperative day, which did not significantly improve with immediate cerebrospinal fluid drainage but fully recovered after urgent left carotid-subclavian bypass.

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