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NGHIÊN CỨU LÂM SÀNG Issue: Issue 99, 2022

Incidence, risk factors of spinal cord ischemia after thoracic endovascular aortic repair for acute complicated type B aortic dissection

Lê Xuân Thận: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Phạm Minh Tuấn: Bộ môn Tim mạch, Đại học Y Hà Nội; Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Nguyễn Ngọc Quang: Bộ môn Tim mạch, Đại học Y Hà Nội; Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Phạm Mạnh Hùng: Bộ môn Tim mạch, Đại học Y Hà Nội; Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai;
Published: November 1, 2021
Views: 157
DOI 10.58354/jvc.99.2022.9

Abstract

Background: Spinal cord ischemia (SCI) is a feared complication after thoracic endovascular aortic repair (Tevar). The purpose of this study to assess the incidence, risk factors of spinal cord ischemia after Tevar to treat acute compicated type B aortic dissection.

Methods: This is a observe study type.
Results: One hundred and two patients underwent Tevar procedures for acute complicated type B aortic dissection were enrolled in the study, The technical success of Tevar was 98,04%, 5 patients (4.90%) developed SCI after Tevar. Mean age of this study was 57,6 ± 10,4. Early detection and treatment of SCI with raise blood pressure and combination with lumbar cerebrospinal fluid (CSF) drainage. All patients to discharge experienced complete neurologic recovery. Logistic regression analysis demonstrated length of coverage of 270mm to be associated with SCI (OR=10,11; 95%CI: 1,41 – 72,55;p=0,021). A significantly higher incidence of post Tevar hypotension was found in the SCI group (60% vs 0%, p<0,001)
Conclusion: Spinal cord ischemia after Tevar is an uncommon, challerging complication. Perioperative hypotension and long segment coverage of aorta was indentified as a risk factor the development of SCI.

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Section NGHIÊN CỨU LÂM SÀNG
Issue Issue 99, 2022