[Paraplegia secondary to surgery of the abdominal aorta].
We report the case of an 84 year-old man who suffered of paraplegia after surgery of an abdominal aortic aneurysm. The neurologic status did not improve during 5 years of follow-up. This complication is rare in light of the review of the literature. It is more frequent after emergency (1.4%) and redux (19%) surgery than after elective surgery (1.1%). Its mechanisms are anatomic (occlusion of the Adamkievitz artery and of the pelvic collateral arteries) and hemodynamic mechanisms (thromboembolism, low systemic tension, long supra-renal clamping). Since pre-operative aortography to detect anatomic variations is not realistic, its only prevention remains maintenance of intra-operative hemodynamic, systemic heparinization, and preservation of the pelvic collateral circulation.
Clavert
P
P
Service de chirurgie Cardio-Vasculaire, Les Hopitaux Universitaires de Strasbourg.
Chakfé
N
N
Edah-Tally
S
S
Beaufigeau
M
M
Hassani
O
O
Thaveau
F
F
Kahn
J L
JL
Kretz
J G
JG
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D006801:Humans; D008297:Male; D010264:Paraplegia / Q000209:etiology*; D011183:Postoperative Complications