Aortic fenestration for chronic aortic dissection type B complicated by transient ischemic attacks of spinal cord

Maraya Altuwaijri, Konstantinos T. Delis, Terri Vrtiska, Jimmy R. Fulgham, Peter Gloviczki

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Spinal cord injury is a rare complication in patients with aortic dissection. The extrinsic arterial supply to the spinal cord, diminishing caudally, often becomes critically dependent on the great radicular artery (GRA) of Adamkiewicz at the thoracolumbar spine. There are no prior reports of spinal injury or ischemia caused by chronic aortic dissection. We report on a 51-year-old patient with chronic type B dissection of the aorta from below the subclavian takeoff through the iliac arteries, presented with multiple episodes of transient (1 to 5 minutes) spinal ischemic attacks, entailing sudden loss of motor and sensory functions in both legs, with collapse of the patient on the ground. GRA imaging acquired with 64-channel computed tomography angiography enabled aortic fenestration from T11 to L1, performed with supraceliac aortic cross-clamping (T8 to L2) via thoracoabdominal access. We critically appraise the pertinent literature.

Original languageEnglish (US)
Pages (from-to)186-193
Number of pages8
JournalJournal of vascular surgery
Volume44
Issue number1
DOIs
StatePublished - Jul 1 2006

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine

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