title: Development of stroke-induced quadriplegia after endovascular repair of blunt aortic injury pseudoaneurysm.
abstract: Endovascular repair of blunt aortic injury is now a first-line approach in management. This can warrant coverage of the left subclavian artery (LSA), which could lead to posterior strokes. In this case report, we present a severe complication of endovascular repair of a traumatic aortic aneurysm. A 53-year-old man presented with blunt aortic injury, endovascular repair was carried out where the left subclavian artery was covered. The intervention had a 100% technical success. Twelve hours later, he was discovered to have quadriplegia, a CT scan showed a large left cerebellar infarction extending to the medulla oblongata and proximal spinal cord. Strokes complicate 3% of thoracic endovascular aortic repairs, 80% of those strokes occur in patients who had their LSA`s covered. Most patients however, tolerate the coverage. Although our patient had a dominant right vertebral artery, and lacked risks for these strokes, he developed an extensive stroke that left him quadriplegic.
authors: Department of Medicine, Faculty of Medicine, King Abdul-Aziz University, PO Box 52234, Jeddah 21563, Kingdom of Saudi Arabia. Fax. +966 (12) 6973143. E-mail: abdullah.s.amoudi@gmail.com.
authors: Abdullah S
authors: AS
authors: Amoudi
authors: Anas A
authors: AA
authors: Merdad
authors: Ahmed Q
authors: AQ
authors: Makhdoom
authors: Reda A
authors: RA
authors: Jamjoom
mesh_terms: D017541:Aneurysm, False / Q000175:diagnosis / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D057510:Endovascular Procedures; D006801:Humans; D008297:Male; D008875:Middle Aged; D011782:Quadriplegia / Q000175:diagnosis / Q000209:etiology*; D020521:Stroke / Q000150:complications*; D013348:Subclavian Artery / Q000601:surgery*; D016896:Treatment Outcome
references: Ann Thorac Surg. 2007 Oct;84(4):1195-200; discussion 1200
references: 17888969
references: J Endovasc Ther. 2007 Aug;14(4):568-73
references: 17696634
references: Can J Surg. 2005 Aug;48(4):293-7
references: 16149364
references: J Vasc Surg. 2011 Jan;53(1):187-92
references: 20974523
references: J Vasc Surg. 2009 Jun;49(6):1403-8
references: 19497498
references: J Vasc Surg. 2011 Oct;54(4):979-84
references: 21658894
references: Ann Thorac Surg. 2011 Jul;92(1):97-102; discussion 102-3
references: 21718834
references: J Vasc Surg. 2000 Jan;31(1 Pt 1):196-9
references: 10642723