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

• 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

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.