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Spinal cord ischemia after endovascular embolization of a type II endoleak following endovascular aneurysm repair.

Abstract：

BACKGROUND:We report a rare case of severe spinal cord ischemia with neurological consequences in a patient who presented after endovascular treatment of a type II endoleak following endovascular aneurysm repair. METHODS AND RESULTS:An enlarging abdominal aortic aneurysm post-endovascular aneurysm repair was detected owing to a persistent type II endoleak caused by a communication between the iliolumbar and L4 lumbar artery for which the patient underwent supraselective embolization with particles and coils. Immediately after the procedure, the patient experienced an acute onset of neurological symptoms in the right lower limb while limb arterial perfusion remained unaffected. Magnetic resonance imaging-magnetic resonance angiography revealed an acute ischemic process at the L2-L4 level. Further follow-up revealed persistence of the endoleak, and the patient was referred to our institution for open surgical treatment. CONCLUSIONS:To the best of our knowledge, this is the first report of severe spinal cord ischemia after transcatheter embolization of the feeding iliolumbar branches of a type II endoleak. Care must be taken during embolization of the feeding artery of type II endoleaks, which may also supply the spinal cord, to minimize the risk of possible spinal cord ischemia.

journal_name

Ann Vasc Surg

journal_title

Annals of vascular surgery

authors

Ioannou CV,Tsetis DK,Kardoulas DG,Katonis PG,Katsamouris AN

doi

10.1016/j.avsg.2011.12.018

subject

Has Abstract

pub_date

2012-08-01 00:00:00

pages

860.e1-7

issue

6

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(12)00184-7

journal_volume

26

pub_type

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