Open Repair for Ruptured Abdominal Aortic Aneurysm and the Risk of Spinal Cord Ischemia: Review of the Literature and Risk-factor Analysis

• Published in: European journal of vascular and endovascular surgery Vol. 40; no. 5; pp. 589 - 595
• Main Authors: Peppelenbosch, A.G, Vermeulen Windsant, I.C, Jacobs, M.J, Tordoir, J.H.M, Schurink, G.W.H
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.11.2010
• Subjects: Aged; Aged, 80 and over; Aneurysm; Aortic Aneurysm, Abdominal - surgery; Aortic Rupture - surgery; Female; Hospital Mortality; Humans; Incidence; Male; Middle Aged; Paraplegia - epidemiology; Paraplegia - etiology; rAAA; Risk Factors; SCI; Spinal cord ischemia; Spinal Cord Ischemia - epidemiology; Spinal Cord Ischemia - etiology; Surgery; Vascular Surgical Procedures - adverse effects; Spinal cord ischemia; SCI; rAAA; Aneurysm
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2010.07.024

Abstract Objectives Spinal cord ischemia after open surgical repair for rAAA is a rare event. We estimated the current incidence and tried to identify risk factors. We also report a new case. Methods Group A consisted of 10 reports on open repair for rAAA from 1980 until 2009. Only series of ≥100 patients were considered to estimate the incidence. Thirty three case reports from 1956 until 2009 were identified (group B). Case reports from group B were not encountered in group A. Group B patients were stratified according to the type of neurological deficit as described by Gloviczki (type I complete infarction and type II infarction of the anterior two third). Results Group A consisted of 1438 patients. In group A 86% were male with a mean age of 72.1 years. The incidence of post-operative paraplegia was 1.2% (range 0–2.8%). In-hospital mortality was 46.9%. Of the 33 patients of group B were 86% male with a mean age of 68.0 years. Most patients developed a type I (42%) or type II (33%) deficit. In-hospital mortality was 51.6%. No significant differences between different types were encountered. Conclusion Spinal cord ischemia after ruptured AAA is a rare complication with an incidence of 1.2% (range 0–2.8%).