JOURNAL OF CLINICAL SURGERY ›› 2020, Vol. 28 ›› Issue (12): 1182-1186.doi: 10.3969/j.issn.1005-6483.2020.12.029

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Pathogenesis exploration and treatment experience of 7 cases of spinal cord ischemia after endovascular aortic repair

  

  1. Department of General Surgery, the Fifth People's Hospital of Chengdu,Sichuan Province,Chengdu 611130,China
  • Online:2020-12-20 Published:2020-12-20

Abstract: Objective To explore the mechanism and preventive measures of spinal cord ischemia after endovascular aortic repair.
Methods A analysis of 7 patients with spinal cord ischemia (SCI) after endovascular aortic repair in our department from November 2017 to November 2019 was carried out. By summarizing the surgical characteristics and follow-up results, a comparative analysis of the possible risk factors for spinal cord ischemia,as well as targeted prevention and treatment measures.
Results Seven patients with SCI after endovascular aortic repair did not undergo preventive cerebrospinal fluid drainage, including 6 early SCI and 1 delayed SCI;4 patients with renal insufficiency, 6 patients with dyslipidemia and 3 patients with chronic obstructive pulmonary before operation; the average operation time was 2.5±1.35 hours; the average length of aortic isolation was 8 vertebral segments;4 cases were reconstructed branch arteries during operation; 4 cases were treated with therapeutic cerebrospinal fluid drainage after operation.After treatment,the symptoms improved in 2 cases and the prognosis was poor in 5 cases, including 4 deaths.
Conclusion SCI is the result of a combination of factors,and the therapeutic cerebrospinal fluid drainage has limited effect.

Key words: spinal cord ischemia, endovascular aortic repair, cerebrospinal fluid drainage, paraplegia, branch artery

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