Hypogastric Artery Stenting for Chronic Intermittent Spinal Cord Ischemia After Thoracic Endovascular Aortic Repair
Standard
Hypogastric Artery Stenting for Chronic Intermittent Spinal Cord Ischemia After Thoracic Endovascular Aortic Repair. / Gronert, Catharina; Tsilimparis, Nikolaos; Panuccio, Giuseppe; Eleshra, Ahmed; Rohlffs, Fiona; Kölbel, Tilo.
In: J ENDOVASC THER, Vol. 27, No. 5, 01.10.2020, p. 801-804.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Hypogastric Artery Stenting for Chronic Intermittent Spinal Cord Ischemia After Thoracic Endovascular Aortic Repair
AU - Gronert, Catharina
AU - Tsilimparis, Nikolaos
AU - Panuccio, Giuseppe
AU - Eleshra, Ahmed
AU - Rohlffs, Fiona
AU - Kölbel, Tilo
PY - 2020/10/1
Y1 - 2020/10/1
N2 - PURPOSE: To report a case of chronic intermittent spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR) and its successful treatment using hypogastric artery stenting.CASE REPORT: A 79-year-old patient presented in May 2013 with a thoracic aortic aneurysm (TAA) and a contained rupture. He urgently underwent TEVAR that covered 274 mm of descending thoracic aorta without immediate postoperative signs of acute SCI. At 3-month follow-up, he reported repeating incidents of sudden lower extremity weakness leading to a fall with a humerus fracture. A neurological consultation revealed the tentative diagnosis of intermittent SCI caused by TEVAR and initially recommended a conservative approach. During the following year there was no clinical improvement of the symptoms. Computed tomography angiography showed a high-grade stenosis of the right hypogastric artery, which was stented in November 2014 to improve the collateral network of spinal cord perfusion. Following treatment, the patient had no further neurological symptoms; at 32 months after the reintervention, the imaging follow-up documented a patent stent and continued exclusion of the TAA.CONCLUSION: Intermittent neurological symptoms after TEVAR should be suspected as chronic intermittent SCI. The improvement of collateral networks of the spinal cord by revascularization of the hypogastric artery is a viable treatment option.
AB - PURPOSE: To report a case of chronic intermittent spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR) and its successful treatment using hypogastric artery stenting.CASE REPORT: A 79-year-old patient presented in May 2013 with a thoracic aortic aneurysm (TAA) and a contained rupture. He urgently underwent TEVAR that covered 274 mm of descending thoracic aorta without immediate postoperative signs of acute SCI. At 3-month follow-up, he reported repeating incidents of sudden lower extremity weakness leading to a fall with a humerus fracture. A neurological consultation revealed the tentative diagnosis of intermittent SCI caused by TEVAR and initially recommended a conservative approach. During the following year there was no clinical improvement of the symptoms. Computed tomography angiography showed a high-grade stenosis of the right hypogastric artery, which was stented in November 2014 to improve the collateral network of spinal cord perfusion. Following treatment, the patient had no further neurological symptoms; at 32 months after the reintervention, the imaging follow-up documented a patent stent and continued exclusion of the TAA.CONCLUSION: Intermittent neurological symptoms after TEVAR should be suspected as chronic intermittent SCI. The improvement of collateral networks of the spinal cord by revascularization of the hypogastric artery is a viable treatment option.
KW - Aged
KW - Aortic Aneurysm, Thoracic/diagnostic imaging
KW - Aortic Rupture/diagnostic imaging
KW - Blood Vessel Prosthesis Implantation/adverse effects
KW - Chronic Disease
KW - Endovascular Procedures/adverse effects
KW - Humans
KW - Male
KW - Regional Blood Flow
KW - Spinal Cord/blood supply
KW - Spinal Cord Ischemia/diagnostic imaging
KW - Stents
KW - Treatment Outcome
KW - Vascular Patency
U2 - 10.1177/1526602820925445
DO - 10.1177/1526602820925445
M3 - SCORING: Journal article
C2 - 32431245
VL - 27
SP - 801
EP - 804
JO - J ENDOVASC THER
JF - J ENDOVASC THER
SN - 1526-6028
IS - 5
ER -