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Article: Neurological complications following endoluminal repair of thoracic aortic disease

TitleNeurological complications following endoluminal repair of thoracic aortic disease
Authors
KeywordsCerebrospinal fluid drain
Endoluminal repair
Neurological complications
Paraplegia
Stent graft
Stroke
Thoracic aortic disease
Issue Date2007
PublisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00270/
Citation
Cardiovascular And Interventional Radiology, 2007, v. 30 n. 5, p. 833-839 How to Cite?
AbstractOpen surgery for thoracic aortic disease is associated with significant morbidity and the reported rates for paraplegia and stroke are 3%-19% and 6%-11%, respectively. Spinal cord ischemia and stroke have also been reported following endoluminal repair. This study reviews the incidence of paraplegia and stroke in a series of 186 patients treated with thoracic stent grafts. From July 1997 to September 2006, 186 patients (125 men) underwent endoluminal repair of thoracic aortic pathology. Mean age was 71 years (range, 17-90 years). One hundred twenty-eight patients were treated electively and 58 patients had urgent procedures. Anesthesia was epidural in 131, general in 50, and local in 5 patients. Seven patients developed paraplegia (3.8%; two urgent and five elective). All occurred in-hospital apart from one associated with severe hypotension after a myocardial infarction at 3 weeks. Four of these recovered with cerebrospinal fluid (CSF) drainage. One patient with paraplegia died and two had permanent neurological deficit. The rate of permanent paraplegia and death was 1.6%. There were seven strokes (3.8%; four urgent and three elective). Three patients made a complete recovery, one had permanent expressive dysphasia, and three died. The rate of permanent stroke and death was 2.1%. Endoluminal treatment of thoracic aortic disease is an attractive alternative to open surgery; however, there is still a risk of paraplegia and stroke. Permanent neurological deficits and death occurred in 3.7% of the patients in this series. We conclude that prompt recognition of paraplegia and immediate insertion of a CSF drain can be an effective way of recovering spinal cord function and improving the prognosis. © 2007 Springer Science+Business Media, LLC.
Persistent Identifierhttp://hdl.handle.net/10722/83114
ISSN
2015 Impact Factor: 2.144
2015 SCImago Journal Rankings: 0.886
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMorales, JPen_HK
dc.contributor.authorTaylor, PRen_HK
dc.contributor.authorBell, REen_HK
dc.contributor.authorChan, YCen_HK
dc.contributor.authorSabharwal, Ten_HK
dc.contributor.authorCarrell, TWGen_HK
dc.contributor.authorReidy, JFen_HK
dc.date.accessioned2010-09-06T08:37:10Z-
dc.date.available2010-09-06T08:37:10Z-
dc.date.issued2007en_HK
dc.identifier.citationCardiovascular And Interventional Radiology, 2007, v. 30 n. 5, p. 833-839en_HK
dc.identifier.issn0174-1551en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83114-
dc.description.abstractOpen surgery for thoracic aortic disease is associated with significant morbidity and the reported rates for paraplegia and stroke are 3%-19% and 6%-11%, respectively. Spinal cord ischemia and stroke have also been reported following endoluminal repair. This study reviews the incidence of paraplegia and stroke in a series of 186 patients treated with thoracic stent grafts. From July 1997 to September 2006, 186 patients (125 men) underwent endoluminal repair of thoracic aortic pathology. Mean age was 71 years (range, 17-90 years). One hundred twenty-eight patients were treated electively and 58 patients had urgent procedures. Anesthesia was epidural in 131, general in 50, and local in 5 patients. Seven patients developed paraplegia (3.8%; two urgent and five elective). All occurred in-hospital apart from one associated with severe hypotension after a myocardial infarction at 3 weeks. Four of these recovered with cerebrospinal fluid (CSF) drainage. One patient with paraplegia died and two had permanent neurological deficit. The rate of permanent paraplegia and death was 1.6%. There were seven strokes (3.8%; four urgent and three elective). Three patients made a complete recovery, one had permanent expressive dysphasia, and three died. The rate of permanent stroke and death was 2.1%. Endoluminal treatment of thoracic aortic disease is an attractive alternative to open surgery; however, there is still a risk of paraplegia and stroke. Permanent neurological deficits and death occurred in 3.7% of the patients in this series. We conclude that prompt recognition of paraplegia and immediate insertion of a CSF drain can be an effective way of recovering spinal cord function and improving the prognosis. © 2007 Springer Science+Business Media, LLC.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://link.springer.de/link/service/journals/00270/en_HK
dc.relation.ispartofCardioVascular and Interventional Radiologyen_HK
dc.subjectCerebrospinal fluid drainen_HK
dc.subjectEndoluminal repairen_HK
dc.subjectNeurological complicationsen_HK
dc.subjectParaplegiaen_HK
dc.subjectStent graften_HK
dc.subjectStrokeen_HK
dc.subjectThoracic aortic diseaseen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAorta, Thoracic - surgeryen_HK
dc.subject.meshAortic Diseases - epidemiology - surgeryen_HK
dc.subject.meshBlood Vessel Prosthesisen_HK
dc.subject.meshBlood Vessel Prosthesis Implantation - adverse effects - instrumentationen_HK
dc.subject.meshDrainage - methodsen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIncidenceen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshParaplegia - etiology - mortality - pathology - physiopathology - surgeryen_HK
dc.subject.meshRecovery of Functionen_HK
dc.subject.meshSpinal Cord Ischemia - etiology - mortality - pathology - physiopathology - surgeryen_HK
dc.subject.meshStentsen_HK
dc.subject.meshStroke - etiology - mortality - pathology - physiopathologyen_HK
dc.subject.meshTime Factorsen_HK
dc.subject.meshTomography, X-Ray Computeden_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleNeurological complications following endoluminal repair of thoracic aortic diseaseen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0174-1551&volume=30&issue=5&spage=833&epage=839&date=2007&atitle=Neurological+complications+following+endoluminal+repair+of+thoracic+aortic+disease+en_HK
dc.identifier.emailChan, YC: ycchan88@hkucc.hku.hken_HK
dc.identifier.authorityChan, YC=rp00530en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00270-007-9017-6en_HK
dc.identifier.pmid17508247-
dc.identifier.scopuseid_2-s2.0-34848870212en_HK
dc.identifier.hkuros145393en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34848870212&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume30en_HK
dc.identifier.issue5en_HK
dc.identifier.spage833en_HK
dc.identifier.epage839en_HK
dc.identifier.eissn1432-086X-
dc.identifier.isiWOS:000249779700004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridMorales, JP=8082109300en_HK
dc.identifier.scopusauthoridTaylor, PR=35103559200en_HK
dc.identifier.scopusauthoridBell, RE=16306367100en_HK
dc.identifier.scopusauthoridChan, YC=27170769400en_HK
dc.identifier.scopusauthoridSabharwal, T=6603720140en_HK
dc.identifier.scopusauthoridCarrell, TWG=36795384700en_HK
dc.identifier.scopusauthoridReidy, JF=7102684353en_HK
dc.identifier.citeulike2176411-

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