Altuwaijri Maraya, Delis Konstantinos T, Vrtiska Terri, Fulgham Jimmy R, Gloviczki Peter
Department of Vascular Surgery, Mayo Clinic, Gonda Vascular Center, Rochester, MN 55905, USA.
J Vasc Surg. 2006 Jul;44(1):186-93. doi: 10.1016/j.jvs.2006.03.030.
Spinal cord injury is a rare complication in patients with aortic dissection. The extrinsic arterial supply to the spinal cord, diminishing caudally, often becomes critically dependent on the great radicular artery (GRA) of Adamkiewicz at the thoracolumbar spine. There are no prior reports of spinal injury or ischemia caused by chronic aortic dissection. We report on a 51-year-old patient with chronic type B dissection of the aorta from below the subclavian takeoff through the iliac arteries, presented with multiple episodes of transient (1 to 5 minutes) spinal ischemic attacks, entailing sudden loss of motor and sensory functions in both legs, with collapse of the patient on the ground. GRA imaging acquired with 64-channel computed tomography angiography enabled aortic fenestration from T11 to L1, performed with supraceliac aortic cross-clamping (T8 to L2) via thoracoabdominal access. We critically appraise the pertinent literature.
脊髓损伤是主动脉夹层患者中一种罕见的并发症。脊髓的外部动脉供应自尾端逐渐减少，通常严重依赖胸腰椎处的Adamkiewicz大根动脉（GRA）。此前尚无慢性主动脉夹层导致脊髓损伤或缺血的报道。我们报告了一名51岁的患者，患有从锁骨下动脉起始部下方至髂动脉的慢性B型主动脉夹层，出现多次短暂性（1至5分钟）脊髓缺血发作，导致双腿突然运动和感觉功能丧失，患者摔倒在地。通过64排计算机断层扫描血管造影获得的GRA成像显示从T11至L1有主动脉开窗，通过胸腹入路采用膈上主动脉交叉钳夹（T8至L2）进行手术。我们对相关文献进行了批判性评估。
