Abstract:
BACKGROUND:Spinal cord ischemia (SCI) after abdominal aortic aneurysm (AAA) endovascular abdominal aortic aneurysm repair (EVAR) is a rare but devastating complication. The mechanism underlying the occurrence of SCI after EVAR seems to be multifactorial and is underreported and not fully elucidated. The aim of the study was to investigate the clinical outcomes in patients with this serious complication. METHODS:A systematic review of the current literature, as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines, was performed to evaluate the incidence of SCI after elective EVAR. PubMed and Scopus databases were systematically searched. Studies reporting on thoracic endovascular aneurysm repair, open repair of AAAs, and symptomatic or ruptured AAAs were excluded. RESULTS:In total, 18 articles reporting 25 cases were included. The mean age was 74.6 ± 7.6 (range: 60-90) years. The mean diameter of AAAs was 5.96 ± 1.0 cm (range: 4.7-8.3). Six cases also had aneurysms in the common iliac arteries. Seventy-one percent of AAAs had characteristics that made EVAR difficult and technically demanding. The mean operative time was prolonged, 254 ± 104.6 min, and associated with extensive intravascular handling. In 41.6% of cases, additional procedures were performed because of the difficult anatomy. Thirty-two percent of the cases had 1 internal iliac artery (IIA) embolized with coils or covered with the stent graft, and 14% had both IIAs compromised. In most of the cases, SCI symptoms presented immediately after the operation, and in 14.8% of patients, the symptoms had late presentation. Almost all cases had motor loss in the form of paraparesis or paraplegia, 54% of the cases also had diminished sensation, and 29.1% of the cases had urinary and/or fecal incontinence. Heterogeneity was observed regarding the management of the disease; in 6 of the cases, cerebrospinal fluid (CSF) drainage was performed, steroids were administered in 5, and in the other cases, an expectant strategy was selected. In 50% of the cases, only small improvement was seen at follow-up. In 25% of the cases, no improvement was seen, and 25% had almost complete recovery. CONCLUSIONS:Our study identified a common pattern among patients who present SCI after EVAR: difficult anatomy, prolonged operative time, additional procedures, and extensive intravascular handling that may have led to embolization. Patency of pelvic circulation preoperatively is also of importance. Regarding outcomes, only 25% of patients recovered, and in certain cases, CSF drainage may have significantly improved chances for recovery.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Moulakakis KG,Alexiou VG,Karaolanis G,Sfyroeras GS,Theocharopoulos GN,Lazaris AM,Kakisis JD,Geroulakos Gdoi
10.1016/j.avsg.2018.03.042subject
Has Abstractpub_date
2018-10-01 00:00:00pages
280-291eissn
0890-5096issn
1615-5947pii
S0890-5096(18)30417-5journal_volume
52pub_type
杂志文章abstract::Small-sized vessels can represent a contraindication to standard endovascular aortic repair (EVAR), and more specifically, aortoiliac deformities resulting from poliomyelitis may add an adjunctive challenge for total endovascular repair. Herein we report a case of a 62-year-old man with a 55 mm abdominal aortic aneury...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.07.019
更新日期:2020-11-01 00:00:00
abstract::This review of 11 cases of seat-belt associated blunt abdominal aortic trauma, includes nine cases reported in the literature and two new cases. Lap-type seat belts were the cause of this injury in eight of the 11 patients (73%). Clinical presentation was acute in 73% of the cases, with symptoms of acute arterial insu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02000502
更新日期:1990-07-01 00:00:00
abstract::Although the histologic effects of balloon catheter thromboembolectomy in arteries are well described, little is known about its effects on arterialized vein grafts. A chronic canine model was used to compare the intimal hyperplasia that develops following balloon catheter thrombectomy versus thrombolytic therapy when...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900091
更新日期:1997-11-01 00:00:00
abstract::Emergency aortic arch surgery still remains a challenge, especially in elderly patients. We report a case about the open surgical management by graft-to-endograft anastomosis of a complicated aortic arch aneurysm because of a type I endoleak after thoracic endovascular aortic repair of a chronic type B aortic dissecti...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.11.015
更新日期:2011-05-01 00:00:00
abstract::An 8-year retrospective review of Indiana University Hospital records consisting of any patient age 18 to 40 years old who presented with arterial mesenteric ischemia was performed. Three patients were identified that met our criteria. The first patient was discovered to have a protein C deficiency. The second patient...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0305-3
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:The goals of this study were to evaluate mid-term outcome in endovascular aortic repair (EVAR) of abdominal aortic aneurysm (AAA) using a GORE C3 EXCLUDER and compare results between patients treated within and outside the instructions for use (IFU). METHODS:Over a 3-year period spanning October 2013 to Sep...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.12.090
更新日期:2019-08-01 00:00:00
abstract::A case-control study was undertaken to determine if asymptomatic carotid artery stenosis (ACS) is independently associated with ipsilateral hemispheric stroke following cardiac surgery (CS). All CS patients (3069) who were at two hospitals between 1989 and 1994 were reviewed. Cases (31) selected for this study were th...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910036
更新日期:2000-05-01 00:00:00
abstract::Prosthetic graft interposition is performed in some patients with coarctation of the aorta (CoA), and all procedures for treating CoA are associated with a risk of aneurysm formation at the site of repair. A 53-year-old woman underwent coarctectomy and descending aortic replacement with a 16-mm Dacron graft for CoA wh...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.01.021
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Aortic sac hygroma and concealed endoleaks (EL) after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm needs particular attention with aggressive management as they are associated with rapid sac expansion and rupture risk. However, they can be erroneously reported as type IV or V EL with supi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.11.039
更新日期:2020-12-29 00:00:00
abstract::In an attempt to reduce early and late mortality caused by myocardial infarction in patients with aortic aneurysms, coronary arteriography and, when indicated, myocardial revascularization were performed prior to elective aortic reconstruction in 302 patients with infrarenal (289) or thoracoabdominal (13) aortic aneur...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60700-0
更新日期:1986-05-01 00:00:00
abstract::We report herein a feasibility study of a minimally invasive endovascular femoropopliteal bypass procedure. The steps include the following: (1) a small groin incision to expose the femoral artery, (2) guidewire passage and mechanical dilatation of the diseased superficial femoral artery, (3) semiclosed endarterectomy...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02015314
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:The endovascular approach has been widely used for aortoiliac occlusive disease (AIOD), especially for aortic bifurcation and iliac artery Trans-Atlantic Inter-Society Consensus II (TASC-II) A and B lesions. However, the outcomes of self-expanding covered stents (SECSs) for extensive aortoiliac lesion remain...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.04.055
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Prosthetic graft occlusion following vascular reconstruction is a major cause of morbidity commonly necessitating further limb-salvage revascularization or life-saving amputation. It is therefore surprising that there is scant data in the literature regarding the optimal management of any remnant prosthetic ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2013.12.034
更新日期:2014-08-01 00:00:00
abstract::Celiac aortic localization of mycotic pseudoaneurysm is serious. The conventional treatment, resection of infected tissues with in situ revascularization, is associated with a high surgical morbid-mortality rate. We report a case of mycotic pseudoaneurysm of the abdominal aorta involving visceral arteries excluded by ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.01.010
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Venous resection during pancreaticoduodenectomy for the excision of pancreatic cancer allows for a more complete resection with negative margins, which increases survival. When the resected vein is greater than 3 cm, reconstruction with an interposition graft is recommended. However, consensus regarding the ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.11.008
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Massive bleeding in patients with aortoenteric fistula (AEF) may be preceded by minor, intermittent gastrointestinal (GI) blood loss, termed the "herald bleed." The aims of this retrospective study were to: (i) analyze the interval between the herald bleed and onset of major GI hemorrhage and/or diagnosis of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.03.028
更新日期:2016-10-01 00:00:00
abstract::Balloon angioplasty produces a mechanically induced injury to the blood vessel wall. Heat shock protein 70 (HSP70) is a molecular chaperone whose expression can be induced by chemical or thermal stress. Thus, we hypothesized that the mechanical injury associated with balloon angioplasty would lead to increases in the ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900286
更新日期:1999-09-01 00:00:00
abstract::We present our experience with 5 patients with chronic limb threatening ischemia (CLTI) treated with distal revascularization and omental flap coverage. We decided to investigate the efficacy and safety of negative-pressure wound therapy (NPWT) in promoting the fixation and remodeling of the omental flap as there is s...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.03.006
更新日期:2018-10-01 00:00:00
abstract::The objective of this study was to compare magnetic resonance angiography (MRA), contrast arteriography (CA), and duplex arteriography (DA) for defining anatomic features relevant to performing lower extremity revascularizations. From March 1, 2001 to August 1, 2001, 33 consecutive inpatients with chronic lower extrem...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0039-0
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine early and mid-term outcomes after open repair of thoracoabdominal aortic aneurysm, with moderate to deep hypothermia as part of proximal aortic management. METHODS:Between April 2009 and March 2015, 44 patients underwent thoracoabdominal aortic repair by total cardiopu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.08.021
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Noninvasive diagnostic testing may be beneficial to identify stenotic (failing) stents placed for occlusive lower extremity peripheral arterial disease (LEPAD), especially if subsequent intervention proves useful in maintaining prolonged stent patency. We previously documented the benefit of surveillance dup...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.08.086
更新日期:2020-02-01 00:00:00
abstract::Duodenocaval fistula (DCF), an unusual pathology, is associated with a 40% mortality rate in the 36 patients previously reported. Although migrating or ingested foreign bodies, trauma, and peptic ulcer disease are often described etiologies, 11 patients have been described who developed DCF after resection of retroper...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/s10016-003-0097-8
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:To propose a protocol for the routine clinical use of duplex ultrasound (DUS) assessment after transcarotid artery revascularization (TCAR) procedures, with its specific point of vascular access, based on DUS data from routine clinical practice. METHODS:DUS data were retrospectively collected at 2 centers f...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.09.065
更新日期:2020-11-24 00:00:00
abstract:BACKGROUND:Isolated bilateral profunda femoris artery aneurysm (PFAA) is a very rare entity. Most of the cases are unilateral and occur with synchronous aneurysms elsewhere. Symptoms range from none to limb ischemia or hemorrhage because of rupture. METHODS:We present a rare case of PFAA. In contrast to the general ru...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.02.025
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Fully implantable catheters are important for oncology treatments. They can be functionally categorized as valved or nonvalved. Theoretically, a valve prevents spontaneous blood reflux into the catheter, reducing the incidence of complications. We sought to compare the results from the implantation of valved...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.01.025
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Patient-centered research requires active engagement of patients. The vascular Ehlers-Danlos Syndrome (vEDS) research collaborative was established to ascertain patient-centered vEDS research priorities and to engage affected individuals as research partners. Evaluation of access to information and interest ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.06.010
更新日期:2020-01-01 00:00:00
abstract::Remote endarterectomy is a minimally invasive technique for revascularization that shortens hospital length of stay and reduces patient morbidity and mortality. With the use of the MollRing Cutter (Vascular Architects, Inc., San Jose, CA), a modification of the single ring stripper, the surgeon is able to cut the endo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0005-z
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:This report examines the effects of regional versus general anesthesia for infrainguinal bypass procedures performed in the treatment of critical limb ischemia (CLI). METHODS:Nonemergent infrainguinal bypass procedures for CLI (defined as rest pain or tissue loss) were identified using the 2005 to 2008 Amer...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.04.006
更新日期:2013-02-01 00:00:00
abstract::This prospective study was undertaken to evaluate the role of duplex Doppler (DD) scanning in the diagnosis of masses of suspected vascular origin at the carotid bifurcation. We also assessed the different DD signs of carotid body tumors, especially the difference in resistance index (RI) in the external carotid arter...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02001007
更新日期:1993-03-01 00:00:00
abstract::Cervical aortic arch (CAA) is a rare vascular malformation which sometimes accompanies other cardiovascular malformations. Surgical approaches such as a lateral thoracotomy and a median sternotomy are selected depending on the position and type of aneurysm and other associated malformations. We herein report the case ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2007.07.028
更新日期:2008-01-01 00:00:00