2024 Volume 28 Issue 1 Pages 91-95
The incidence of paraplegia in thoracic endovascular aortic repair (TEVAR) is considered to be lower than that in open surgical repair; however, once it occurs, it can be a serious problem affecting the patient's prognosis. Cerebrospinal fluid drainage (CSFD), known as spinal cord protection strategy, is recommended selectively for patients at high risk of paraplegia, such as patients with planned extensive thoracic aorta coverage (>200 mm) or previous abdominal aorta aneurysm repair. Careful management is required because the procedure itself can sometimes cause serious complications. We report a case of acute postoperative paraplegia in a 78-year-old man who underwent TEVAR and fenestrated endovascular aortic repair (F-EVAR) for a Crawford classification II thoracoabdominal aortic aneurysm. Various treatments including CSFD were performed, and the paraplegia improved. However, an epidural hematoma, possibly caused by CSFD, became a problem. This is a case that requires careful consideration regarding spinal cord protection strategies.
