Spinal cord injury as a complication of thoracic endovascular aneurysm repair

Surg Today. 2018 May;48(5):473-477. doi: 10.1007/s00595-017-1588-5. Epub 2017 Sep 18.

Abstract

Objective: Spinal cord ischemia (SCI) is a devastating complication of thoracic aortic aneurysm repair in the era of thoracic endovascular aneurysm repair (TEVAR). This review aims to clarify the causes of SCI during TEVAR and to propose ways that it may be prevented.

Methods and results: We performed an extensive literature search of SCI during TEVAR. Based on the existing literature, we examined the anatomy of the anterior spinal cord artery, which supplies blood to the anterior aspect of the spinal cord, and discuss reported effective ways to prevent SCI during TEVAR, including augmentation of arterial blood pressure and drainage of cerebrospinal fluid.

Conclusion: After reviewing the mechanism of SCI during TEVAR, we evaluated promising preventative measures.

Keywords: Descending thoracic aortic aneurysm; Paraplegia; Spinal cord ischemia; Thoracic endovascular aneurysm repair (TEVAR).

Publication types

  • Review

MeSH terms

  • Aortic Aneurysm, Thoracic / surgery*
  • Arteries / anatomy & histology
  • Endovascular Procedures / adverse effects*
  • Endovascular Procedures / methods*
  • Humans
  • Postoperative Complications / etiology*
  • Postoperative Complications / prevention & control*
  • Risk Factors
  • Spinal Cord / blood supply
  • Spinal Cord Ischemia / etiology*
  • Spinal Cord Ischemia / prevention & control*