Spinal Cord Ischaemia Following Fenestrated Endovascular Aortic Repair for Infrarenal Aortic Aneurysm: Report of a Rare Complication and Its Successful.

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Presentation transcript:

Spinal Cord Ischaemia Following Fenestrated Endovascular Aortic Repair for Infrarenal Aortic Aneurysm: Report of a Rare Complication and Its Successful Treatment D. Misselhorn, T. Beresford, A. Laing, A. Khanafer EJVES Extra Volume 26, Issue 2, Pages e24-e26 (August 2013) DOI: 10.1016/j.ejvsextra.2013.04.003 Copyright © 2013 European Society for Vascular Surgery Terms and Conditions

Figure 1 (A,B) Computed tomography angiography reconstruction of infrarenal abdominal aortic aneurysm prior to treatment. (C) Angiogram of right iliac limb dilatation. Note the difference between tapered shape of right and flared shape of left tip of limb (black arrows) which could hint towards accidental positioning of tip of limb within the origin of the smaller calibre EIA. (D, E) Reconstruction of the abdominal aorta and iliac arteries after FEVAR with chronic occluded left internal iliac artery (IIA). (D) Occlusion of right IIA (white arrow) by the right iliac limb. (E) Patent right IIA (white arrow) after revascularisation and balloon expandable stent angioplasty. EJVES Extra 2013 26, e24-e26DOI: (10.1016/j.ejvsextra.2013.04.003) Copyright © 2013 European Society for Vascular Surgery Terms and Conditions

Figure 2 Abdominal aorta and iliac arteries with branches involved in spinal cord perfusion which are prone to be occluded by distal aortic repair. AAA = abdominal aortic aneurysm; CIA = common iliac artery; CT = coeliac trunk; EIA = external iliac artery; GRA = great radicular artery (Adamkiewicz artery); ICAa = intercostal arteries; IIA = internal iliac artery; ILA = iliolumbar artery; IMA = inferior mesenteric artery; LAa = lumbar arteries; LRAa = lumbar radicular arteries; LSAa = lateral sacral arteries; MA = marginal artery; MRA = middle rectal artery; MSA = middle sacral artery; OA = obturator artery, which anastomosis with the profunda femoral artery via the medial circumflex femoral artery; SMA = superior mesenteric artery; SRA = superior rectal artery; TRAa = thoracic radicular arteries. EJVES Extra 2013 26, e24-e26DOI: (10.1016/j.ejvsextra.2013.04.003) Copyright © 2013 European Society for Vascular Surgery Terms and Conditions