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Identifying paraplegia risk associated with thoracic endografting.
- Source :
-
Asian cardiovascular & thoracic annals [Asian Cardiovasc Thorac Ann] 2009 Dec; Vol. 17 (6), pp. 568-72. - Publication Year :
- 2009
-
Abstract
- Endografting, like open surgical repair of the thoracic aorta, can be complicated by paraplegia. We reviewed our thoracic endografting experience regarding the incidence and treatment of spinal cord neurologic events. Between February 2000 and July 2008, 346 patients underwent endoluminal grafting of the descending thoracic aorta. Indications for intervention included atherosclerotic aneurysms (45.9%), acute and chronic dissections (31.5%), miscellaneous lesions (13.6%), and penetrating aortic ulcers (8.9%). Ten women and 4 men (4.0%), with a mean age of 71.3 years, developed either paraparesis (1.7%) or paraplegia (2.3%). Nine (64.3%) of these patients had an aneurysm, 4 (28.6%) had acute or chronic type B aortic dissection, and 1 (7.1%) had a penetrating aortic ulcer; 3 (21.4%) of them had previously undergone open abdominal aortic aneurysm repair, and 13 (92.9%) required coverage of more than 20 cm of the aorta. Cerebrospinal fluid drainage was instituted in 7/8 paraplegic patients. Eight (57.1%) of the 14 patients recovered fully, 2 (14.3%) experienced partial recovery, and 4 (28.6%) had significant neurological deficits. Paraplegia following thoracic endografting appears to be associated with female sex, long-segment coverage of the thoracic aorta, and aneurysmal disease.
- Subjects :
- Adult
Aged
Aged, 80 and over
Aortic Dissection surgery
Aorta, Thoracic diagnostic imaging
Aortic Aneurysm, Thoracic surgery
Aortic Diseases complications
Aortic Diseases diagnostic imaging
Aortic Diseases epidemiology
Aortography methods
Arizona epidemiology
Databases as Topic
Female
Humans
Incidence
Male
Middle Aged
Paraparesis epidemiology
Paraplegia epidemiology
Prospective Studies
Risk Assessment
Risk Factors
Sex Factors
Spinal Cord Ischemia epidemiology
Tomography, X-Ray Computed
Treatment Outcome
Ulcer surgery
Young Adult
Aorta, Thoracic surgery
Aortic Diseases surgery
Blood Vessel Prosthesis Implantation adverse effects
Paraparesis etiology
Paraplegia etiology
Spinal Cord Ischemia etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1816-5370
- Volume :
- 17
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Asian cardiovascular & thoracic annals
- Publication Type :
- Academic Journal
- Accession number :
- 20026530
- Full Text :
- https://doi.org/10.1177/0218492309349813