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PARAPLEGIA IN TEVAR

Author : Mark Austin Ramirez,

MD St. Luke’s Medical Center, Quezon City


ABSTRACT

This is a case of a72 year old male diagnosed with descending thoracic aortic aneurysm. Eventually underwent AntegradeThroracic Endovascular Aortic Repair (TEVAR) with full debranching of the aortic branches. Post operatively, patient presented with paraplegia. Paraplegia is a rare but debilitation complication of thoracic aortic procedures. Mechanism of Spinal Cord Ischemia include coverage of critical intercostals leading to immediate paraplegia, episodes of hypotension with subsequent loss of collaterals, delayed thrombosis of intercostal arteries and visceral ischemia from abdominal repair or embolization with release of cytokines and cord edema. The combination of co-morbidity in our patient may have predispose him to develop paraplegia.

Figure 1. Dilated proximal descending aorta measuring 8.4 cm in its greatest diameter relating to a fusiform aneurysm with note of thrombus formation in its walls as well as atherosclerotic plaques

Figure 2. 3d reconstruction showing aneurysms of the aorta (Thoracic, abdominal and common iliac arteries)


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