OBJECTIVE: To evaluate intercostal artery patency following thoracic endovascular aortic repair (TEVAR) and its relationship with spinal cord ischemia (SCI). METHODS: Patients with SCI (n = 7) and a matched control cohort (n = 18) were identified from a prospectively maintained database. Radiographic analysis of intercostal patency was assessed using 3-dimensional (3-D)-reconstructed images of pre- and postoperative CT angiograms (1-6 months, 6-12 months, and 1-5 years). RESULTS: Patients with SCI had a higher incidence of perioperative hypotension (P < .01) and longer procedure duration (P = .01). While the mean number of patent intercostal arteries at each time interval was not significantly different between groups, both SCI (P = .002) and control (P <.001) groups demonstrated a significant reduction in patent intercostal arteries in the stented area of the aorta following TEVAR. CONCLUSION: TEVAR decreases intercostal artery patency in the area of aortic coverage. Our data suggest that intercostal artery patency, in conjunction with perioperative hypotension, is an important contributor to postoperative SCI.
OBJECTIVE: To evaluate intercostal artery patency following thoracic endovascular aortic repair (TEVAR) and its relationship with spinal cord ischemia (SCI). METHODS:Patients with SCI (n = 7) and a matched control cohort (n = 18) were identified from a prospectively maintained database. Radiographic analysis of intercostal patency was assessed using 3-dimensional (3-D)-reconstructed images of pre- and postoperative CT angiograms (1-6 months, 6-12 months, and 1-5 years). RESULTS:Patients with SCI had a higher incidence of perioperative hypotension (P < .01) and longer procedure duration (P = .01). While the mean number of patent intercostal arteries at each time interval was not significantly different between groups, both SCI (P = .002) and control (P <.001) groups demonstrated a significant reduction in patent intercostal arteries in the stented area of the aorta following TEVAR. CONCLUSION: TEVAR decreases intercostal artery patency in the area of aortic coverage. Our data suggest that intercostal artery patency, in conjunction with perioperative hypotension, is an important contributor to postoperative SCI.
Authors: Kenneth DeSart; Salvatore T Scali; Robert J Feezor; Michael Hong; Philip J Hess; Thomas M Beaver; Thomas S Huber; Adam W Beck Journal: J Vasc Surg Date: 2013-04-13 Impact factor: 4.268
Authors: Salvatore T Scali; S Keisin Wang; Robert J Feezor; Thomas S Huber; Tomas D Martin; Charles T Klodell; Thomas M Beaver; Adam W Beck Journal: J Vasc Surg Date: 2014-10-03 Impact factor: 4.268
Authors: Paul A Lapchak; Paul D Boitano; Rene Bombien; Daisy Chou; Margot Knight; Anja Muehle; Mihaela Te Winkel; Ali Khoynezhad Journal: Neural Regen Res Date: 2019-12 Impact factor: 5.135