title: Spinal cord, bowel, and buttock ischemia after endovascular aneurysm repair.
abstract: A 66-year-old man with multiple comorbidities presented with a juxtarenal perianastomotic aortic aneurysm 10 years after open abdominal aortic aneurysm repair. The aneurysmal disease also involved both iliac bifurcations, the right internal iliac artery, the left common femoral artery (CFA) up to its bifurcation, and the homolateral popliteal artery. We performed bilateral internal iliac artery coil embolization 1-month apart. Later, we performed aortouniiliac endografting extending to the right external iliac artery and placement of an endovascular plug in the left external iliac artery. A right CFA to left femoral bifurcation bypass graft was then constructed after ligation of the left CFA aneurysm. After recovering from anesthesia and despite sequential hypogastric embolization, the patient developed postoperative paraplegia, buttock ischemia, and ischemic colitis and died on postoperative day 5. The possible pathogenic mechanisms involved in the onset of these ischemic complications are discussed in this article.
authors.affiliation: Department of Vascular and Endovascular Surgery, University of Bari, Bari, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Angiletta
authors.forename: Davide
authors.initials: D
authors.lastname: Marinazzo
authors.forename: Gloria
authors.initials: G
authors.lastname: Guido
authors.forename: Luigi
authors.initials: L
authors.lastname: Greco
authors.forename: Guido
authors.initials: G
authors.lastname: Regina
mesh_terms: D000368:Aged; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D002081:Buttocks / Q000098:blood supply*; D017091:Colitis, Ischemic / Q000209:etiology; D003097:Collateral Circulation; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000009:adverse effects*; D017809:Fatal Outcome; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D017543:Iliac Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D010264:Paraplegia / Q000209:etiology; D020760:Spinal Cord Ischemia / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D014057:Tomography, X-Ray Computed