scholarly journals Clinical Outcomes of Spinal Cord Ischemia After Fenestrated and Branched Endovascular Stent Grafting During Total Endovascular Aortic Repair for Thoracoabdominal Aortic Aneurysms

2017 ◽  
Vol 66 (5) ◽  
pp. 1626
Author(s):  
T. Baba ◽  
T. Ohki ◽  
Y. Kanaoka ◽  
K. Maeda ◽  
H. Ohta ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Clinical Outcomes ◽  
Spinal Cord Ischemia ◽  
Aortic Aneurysms ◽  
Endovascular Aortic Repair ◽  
Endovascular Stent ◽  
Stent Grafting ◽  
Endovascular Stent Grafting ◽  
Aortic Repair

scholarly journals Regarding “Recurrent spinal cord ischemia after endovascular stent grafting for chronic traumatic aneurysm of the aortic isthmus”

2016 ◽  
Vol 63 (2) ◽  
pp. 567-568
Author(s):  
Nikola S. Ilic ◽  
Igor Končar ◽  
Dragan Markovic ◽  
Marko Dragaš ◽  
Dusan Kostic ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Ischemia ◽  
Endovascular Stent ◽  
Traumatic Aneurysm ◽  
Stent Grafting ◽  
Aortic Isthmus ◽  
Endovascular Stent Grafting

“Awake” Spinal Cord Monitoring Under Local Anesthesia and Conscious Sedation in Fenestrated and Branched Endovascular Aortic Repair

2021 ◽  
pp. 152660282110282
Author(s):  
Said Abisi ◽  
Liam Musto ◽  
Oliver Lyons ◽  
Michelle Carmichael ◽  
Morad Sallam ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Length Of Stay ◽  
Local Anesthesia ◽  
Endovascular Repair ◽  
Conscious Sedation ◽  
Spinal Cord Ischemia ◽  
Aortic Aneurysms ◽  
Endovascular Aortic Repair ◽  
Aortic Repair ◽  
Spinal Drain

Introduction Endovascular repair of thoracoabdominal aortic aneurysms carries a risk of spinal cord ischemia, the causes of which remain uncertain. We hypothesized that local anesthesia (LA) with conscious sedation could abrogate the potential suppressive cardiovascular effects of general anesthesia (GA) and facilitate intraoperative monitoring of neurological function. Here, we examine the feasibility of this technique during fenestrated (FEVAR) or branched endovascular aortic repair (BEVAR). Materials and Methods Consecutive patients undergoing FEVAR or BEVAR under LA and conscious sedation by a team at a single center were analyzed. Patients received conscious sedation using intravenous remifentanil and propofol infusions in conjunction with a local anesthetic agent. No patient had a prophylactic spinal drain inserted. Outcome measures included conversion to GA, need for vasopressors and/or spinal drainage, length of stay, complications, and patient survival. Results A total of 44 patients underwent FEVAR or BEVAR under LA and conscious sedation. The cohort included thoracoabdominal aortic aneurysms (n=41) and pararenal aneurysms treated with endografts covering the supraceliac segment (n=3). Four patients (9%) required conversion to GA at a median operative duration of 198 minutes (range 97–495 minutes). Vasopressors were required intraoperatively in 3 of the cases that were converted to GA. No patient developed spinal cord ischemia and none had insertion of a spinal drain. The median hospital length of stay was 4 days (range 2–41 days). Postoperative delirium and hospital-acquired pneumonia was seen in 7% of patients. All patients survived to 30 days, with 95% alive at a median follow-up of 15 months (range 3–26 months). Conclusion LA and conscious sedation is a feasible anesthetic technique for the endovascular repair of thoracoabdominal aortic aneurysms.

Hypogastric Artery Stenting for Chronic Intermittent Spinal Cord Ischemia After Thoracic Endovascular Aortic Repair

2020 ◽  
Vol 27 (5) ◽  
pp. 801-804
Author(s):  
Catharina Gronert ◽  
Nikolaos Tsilimparis ◽  
Giuseppe Panuccio ◽  
Ahmed Eleshra ◽  
Fiona Rohlffs ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Ischemia ◽  
Thoracic Endovascular Aortic Repair ◽  
Neurological Symptoms ◽  
Endovascular Aortic Repair ◽  
Hypogastric Artery ◽  
Lower Extremity Weakness ◽  
Aortic Repair ◽  
The Right

Purpose: To report a case of chronic intermittent spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR) and its successful treatment using hypogastric artery stenting. Case Report: A 79-year-old patient presented in May 2013 with a thoracic aortic aneurysm (TAA) and a contained rupture. He urgently underwent TEVAR that covered 274 mm of descending thoracic aorta without immediate postoperative signs of acute SCI. At 3-month follow-up, he reported repeating incidents of sudden lower extremity weakness leading to a fall with a humerus fracture. A neurological consultation revealed the tentative diagnosis of intermittent SCI caused by TEVAR and initially recommended a conservative approach. During the following year there was no clinical improvement of the symptoms. Computed tomography angiography showed a high-grade stenosis of the right hypogastric artery, which was stented in November 2014 to improve the collateral network of spinal cord perfusion. Following treatment, the patient had no further neurological symptoms; at 32 months after the reintervention, the imaging follow-up documented a patent stent and continued exclusion of the TAA. Conclusion: Intermittent neurological symptoms after TEVAR should be suspected as chronic intermittent SCI. The improvement of collateral networks of the spinal cord by revascularization of the hypogastric artery is a viable treatment option.

scholarly journals National Incidence, Mortality Outcomes, and Predictors of Spinal Cord Ischemia After Thoracic Endovascular Aortic Repair

2019 ◽  
Vol 69 (1) ◽  
pp. e15-e16 ◽  
Author(s):  
Salvatore T. Scali ◽  
Kristina A. Giles ◽  
Grace J. Wang ◽  
Thomas S. Huber ◽  
Gilbert R. Upchurch ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Ischemia ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Repair

scholarly journals PC072. Impact of Functional Recovery and Prediction of Spinal Cord Ischemia After Thoracic Endovascular Aortic Repair in the Vascular Quality Initiative

2016 ◽  
Vol 63 (6) ◽  
pp. 174S-175S
Author(s):  
Liza Flory P. Laquian ◽  
Salvatore Scali ◽  
Robert Feezor ◽  
Javairiah Fatima ◽  
Kristina A. Giles ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Functional Recovery ◽  
Spinal Cord Ischemia ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Repair

Endovascular stent grafting of aortic aneurysms

2004 ◽  
Vol 22 (11) ◽  
pp. 297-299
Author(s):  
Dominic Fay ◽  
Michael G Wyatt ◽  
John Rose
Keyword(s):  
Aortic Aneurysms ◽  
Endovascular Stent ◽  
Stent Grafting ◽  
Endovascular Stent Grafting
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