A Case of Elective Abdominal Aortic Aneurysm Complicated with Postoperative Paraplegia

Abstract

Spinal cord ischemia is an extremely rare but severe complication following infrarenal abdominal aortic aneurysm repair and occurs in approximately 0.1 to 0.2% of elective cases. We present a case of a 79-year-old man who developed paraplegia due to spinal cord ischemia after an elective repair for a 50 mm infrarenal aortic aneurysm. The procedure involved infrarenal aortic clamping and aorto-bilateral external and internal iliac reconstruction. Three pairs of lumbar arteries were suture ligated. Postoperative paraplegia was neurologically recognized, and spinal cord infarction was confirmed by magnetic resonance imaging. Despite the steroid administration and rehabilitation efforts, there was no discernible improvement in paraplegia, sensory disturbance, or urinary and bowel excretory dysfunction. Currently, no reliable method exists to prevent paraplegia following abdominal aortic aneurysm repair. Although it is an extremely rare, the possibility of this serious complication should be included in preoperative informed consent documents.