title: Impact of intercostal artery occlusion on spinal cord ischemia following thoracic endovascular aortic repair.
abstract: OBJECTIVE
  To evaluate intercostal artery patency following thoracic endovascular aortic repair (TEVAR) and its relationship with spinal cord ischemia (SCI).
  
  
  METHODS
  Patients with SCI (n = 7) and a matched control cohort (n = 18) were identified from a prospectively maintained database. Radiographic analysis of intercostal patency was assessed using 3-dimensional (3-D)-reconstructed images of pre- and postoperative CT angiograms (1-6 months, 6-12 months, and 1-5 years).
  
  
  RESULTS
  Patients with SCI had a higher incidence of perioperative hypotension (P < .01) and longer procedure duration (P = .01). While the mean number of patent intercostal arteries at each time interval was not significantly different between groups, both SCI (P = .002) and control (P <.001) groups demonstrated a significant reduction in patent intercostal arteries in the stented area of the aorta following TEVAR.
  
  
  CONCLUSIONS
  TEVAR decreases intercostal artery patency in the area of aortic coverage. Our data suggest that intercostal artery patency, in conjunction with perioperative hypotension, is an important contributor to postoperative SCI.
authors.affiliation: Division of Vascular Surgery and Endovascular Therapy, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
authors.forename: Brant W
authors.initials: BW
authors.lastname: Ullery
authors.forename: Jon
authors.initials: J
authors.lastname: Quatromoni
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Jackson
authors.forename: Edward Y
authors.initials: EY
authors.lastname: Woo
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Fairman
authors.forename: Nimesh D
authors.initials: ND
authors.lastname: Desai
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Bavaria
authors.forename: Grace J
authors.initials: GJ
authors.lastname: Wang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001013:Aorta, Thoracic / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D016022:Case-Control Studies; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015143:Philadelphia; D018570:Risk Assessment; D012307:Risk Factors; D020760:Spinal Cord Ischemia / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D013895:Thoracic Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency