Preoperative spinal artery localization and its relationship to postoperative neurologic complications.
OBJECTIVE
To evaluate the risk of spinal cord revascularization and ascertain the relationship between preoperative spinal arteriography and the frequency of postoperative neurologic injury and overall morbidity and mortality in patients who require surgical repair of thoracoabdominal aortic aneurysms.


METHODS
Fifty patients scheduled for surgical repair of a thoracoabdominal aortic aneurysm underwent spinal arteriography. All patients were divided into a positive spinal artery group (in which the spinal artery was identified) or negative spinal artery group (in which the spinal artery was not identified) and further divided based on extent of disease.


RESULTS
The complication rate of spinal arteriography was 4.6%; no patient had a permanent neurologic injury. No significant difference existed between the positive and negative spinal artery groups in occurrence of neurologic injury (P = .88) or combined morbidity and mortality (P = 51).


CONCLUSIONS
Patients who require spinal cord revascularization do not have greater frequency of neurologic injury or overall morbidity and mortality than those without this requirement. Spinal arteriography enables definitive spinal cord revascularization and thereby reduces the risk of neurologic injury.
Savader
S J
SJ
Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, MD 21287.
Williams
G M
GM
Trerotola
S O
SO
Perler
B A
BA
Wang
M C
MC
Venbrux
A C
AC
Lund
G B
GB
Osterman
F A
FA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000379:methods; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D001158:Arteries / Q000473:pathology / Q000601:surgery; D003974:Diatrizoate Meglumine; D005071:Evoked Potentials; D005260:Female; D006801:Humans; D007472:Iohexol; D007511:Ischemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology; D011183:Postoperative Complications; D011300:Preoperative Care; D012189:Retrospective Studies; D013116:Spinal Cord / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016896:Treatment Outcome
D003974:Diatrizoate Meglumine; D007472:Iohexol