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肾下腹主动脉瘤腔内修复术后脊髓梗死

Spinal Cord Infarction after Endovascular Aortic Repair for Infrarenal Abdominal Aortic Aneurysm.

作者信息

Konishi Yasunobu, Yano Daisuke, Banno Hiroshi, Kuwabara Fumiaki

机构信息

Department of Cardiovascular Surgery, Nagoya Ekisaikai Hospital, Nagoya, Aichi, Japan.

Division of Cardiovascular Surgery, Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.

出版信息

Ann Vasc Dis. 2024 Sep 25;17(3):317-320. doi: 10.3400/avd.cr.23-00117. Epub 2024 Aug 6.

DOI:10.3400/avd.cr.23-00117
PMID:39359564
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11444833/
Abstract

Spinal cord infarction (SCI) is a rare but serious complication of endovascular aortic repair (EVAR) for abdominal aortic aneurysms (AAA). It is difficult to predict, prevent, and treat and can cause significant impairment. We describe the case of a patient who experienced paraplegia and thermal pain dysfunction of the lower extremities shortly after EVAR for an infrarenal AAA. Immediately after confirming SCI, we initiated cerebrospinal fluid drainage, administered steroids, naloxone, and free radical scavengers, and maintained high blood pressure. However, the patient's symptoms did not improve sufficiently. Since the possibility of a SCI exists, prompt treatment should be initiated.

摘要

脊髓梗死（SCI）是腹主动脉瘤（AAA）血管内主动脉修复术（EVAR）罕见但严重的并发症。它难以预测、预防和治疗，可导致严重功能障碍。我们描述了一例患者，其在接受肾下AAA的EVAR术后不久出现双下肢截瘫和热痛功能障碍。确诊SCI后，我们立即开始进行脑脊液引流，给予类固醇、纳洛酮和自由基清除剂，并维持高血压状态。然而，患者症状改善并不充分。由于存在发生SCI的可能性，应立即展开治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da2/11444833/58c125da74f0/avd-17-317-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da2/11444833/9733486524a9/avd-17-317-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da2/11444833/58c125da74f0/avd-17-317-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da2/11444833/9733486524a9/avd-17-317-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5da2/11444833/58c125da74f0/avd-17-317-g002.jpg

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本文引用的文献

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Outcomes of Endovascular Repair for Abdominal Aortic Aneurysms: A Nationwide Survey in Japan.血管内修复治疗腹主动脉瘤的结果：日本全国性调查。
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8
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J Vasc Surg. 1998 May;27(5):821-8; discussion 829-30. doi: 10.1016/s0741-5214(98)70261-7.
9
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Am J Surg. 1991 Aug;162(2):131-6. doi: 10.1016/0002-9610(91)90174-c.
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Surgery. 1978 Jan;83(1):38-56.