Asian Annals Activate Your Online Account to Asian Annals
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Ourania Preventza
James Williams
Edward B Diethrich
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Preventza, O.
Right arrow Articles by Diethrich, E. B
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Preventza, O.
Right arrow Articles by Diethrich, E. B

ORIGINAL ARTICLE

Identifying Paraplegia Risk Associated with Thoracic Endografting

Ourania Preventza, MD, Grayson H Wheatley, III, MD, James Williams, BS, Venkatesh Ramaiah, MD, Julio Rodriguez-Lopez, MD, Edward B Diethrich, MD

Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute, Phoenix, AZ, USA

Ourania Preventza, MD Tel: +832 355 9910 Email: opsmile01{at}aol.com, Division of Cardiothoracic Surgery, Texas Heart Hospital at St Luke’s Episcopal Hospital, Baylor College of Medicine, MS:BCM 390, One Baylor Plaza, Houston, TX 77030, USA.

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.

Key Words: Aortic Aneurysm • Thoracic • Blood Vessel Prosthesis Implantation • Paraplegia • Spinal Cord Ischemia • Stroke

Asian Cardiovasc Thorac Ann 2009; 17:568-572
© 2009 by SAGE Publications
DOI: 10.1177/0218492309349813




HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2009 by SAGE Publications