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胸主动脉腔内修复术后延迟性瘫痪的左锁骨下动脉血运重建术

Left Subclavian Artery Revascularization for Delayed Paralysis after Thoracic Endovascular Aortic Repair.

作者信息

Nakamura Eisaku, Nakamura Kunihide, Furukawa Koji, Ishii Hirohito, Shirasaki Yukie, Ichiki Nobuhiko, Higuchi Kazuhiro, Sakurahara Daichi, Hamahiro Tomoka

机构信息

Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki, Miyazaki, Miyazaki, Japan.

出版信息

Ann Vasc Dis. 2019 Jun 25;12(2):233-235. doi: 10.3400/avd.cr.18-00158.

Abstract

Spinal cord ischemia (SCI) is a devastating complication following thoracic endovascular aortic repair (TEVAR). A man with a ruptured thoracic aortic aneurysm (TAA) was transferred to our hospital. Emergency TEVAR, with left subclavian artery (LSA) coverage, was performed for the ruptured TAA. On postoperative day two, the patient had incomplete paralysis in his legs, presumably caused by SCI. We performed LSA revascularization (LSAR) to provide blood supply to the spinal cord; his paralysis improved and almost resolved after surgery. To our knowledge, this is the first report on LSAR's efficacy for delayed paraplegia due to SCI.

摘要

脊髓缺血(SCI)是胸主动脉腔内修复术(TEVAR)后一种严重的并发症。一名患有胸主动脉瘤破裂(TAA)的男性被转诊至我院。针对破裂的TAA进行了急诊TEVAR,并覆盖了左锁骨下动脉(LSA)。术后第二天,患者双腿出现不完全瘫痪,推测是由SCI所致。我们进行了LSA血运重建(LSAR)以向脊髓供血;术后其瘫痪症状有所改善且几乎完全消失。据我们所知,这是关于LSAR治疗SCI所致迟发性截瘫疗效的首例报告。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c39e/6600088/13236c77cfc2/avd-12-2-cr.18-00158-figure01.jpg

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