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

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

doi:10.3400/avd.cr.18-00158

CASE REPORTS

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

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

Author information

Eisaku Nakamura Corresponding author
Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki
Kunihide Nakamura
Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki
Koji Furukawa
Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki
Hirohito Ishii
Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki
Yukie Shirasaki
Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki
Nobuhiko Ichiki
Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki
Kazuhiro Higuchi
Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki
Daichi Sakurahara
Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki
Tomoka Hamahiro
Division of Cardiovascular Surgery, Department of Surgery, University of Miyazaki

Keywords: delayed paralysis, thoracic endovascular aortic repair, left subclavian artery revascularization

JOURNAL OPEN ACCESS

2019 Volume 12 Issue 2 Pages 233-235

DOI https://doi.org/10.3400/avd.cr.18-00158

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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.

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