title: An unusual cause of spinal cord ischemia after thoracic endovascular repair.
abstract: A 59-year-old left-handed man presented with chest pain and hypertension and was found to have an acute descending aortic dissection on imaging. After thoracic endovascular repair of the dissection, he developed left arm weakness and ischemia. Despite carotid-subclavian transposition, the patient was found to have persistent left triceps weakness as well as bilateral leg paresis. An urgent spinal drain was placed that improved his lower extremity deficit but did not greatly change his arm symptoms. Magnetic resonance imaging of the spine revealed previously undiagnosed severe multilevel spinal stenosis requiring operative decompression. To our knowledge, this is the first report of the contribution of cervical spinal stenosis to post-thoracic endovascular repair spinal ischemia.
authors.affiliation: Department of Vascular Surgery, Greenville Health Systems, Greenville, USA ikoleilat@ghs.org.
authors.forename: Issam
authors.initials: I
authors.lastname: Koleilat
authors.affiliation: Department of Vascular Surgery, Greenville Health Systems, Greenville, USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Moore
authors.affiliation: Department of Vascular Surgery, Greenville Health Systems, Greenville, USA.
authors.forename: Tod
authors.initials: T
authors.lastname: Hanover
authors.affiliation: Department of Vascular Surgery, Greenville Health Systems, Greenville, USA.
authors.forename: John
authors.initials: J
authors.lastname: Eidt
mesh_terms: D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D019299:Decompression, Surgical; D057510:Endovascular Procedures / Q000009:adverse effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D020760:Spinal Cord Ischemia / Q000175:diagnosis / Q000209:etiology*; D013130:Spinal Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome
keywords: Aortic dissection; TEVAR; spinal ischemia