Impact of preoperative identification of the artery of Adamkiewicz on spinal cord injury after descending aortic and thoracoabdominal aortic repair

• DOI: 10.21037/acs-2023-scp-18
• Publication Date: 2023-09-22T06:18:08Z
• Authors: Toshiki Fujiyoshi; Toru Iwahashi; Hitoshi Ogino
• Keywords: Paraplegia; AKA

Some recent reports have demonstrated that preoperative Adamkiewicz artery (AKA) identification and its targeted reconstruction has provided satisfactory outcomes with respect to spinal cord protection. This paper investigates the impact of AKA on reducing incidence injury (SCI) in open repair (OR) endovascular (EVR) descending thoracic aortic (dTA) thoracoabdominal aneurysm (TAA) repair.The clinical data patients dTA TAA treated between 2011 2022 were investigated. A total 256 comprising 201 males 55 females, a mean age 72.1±10.0 years, included. OR was used 102 EVR 154 whose distal landing zone below T8, all which needed AKA.The identified 207 (80.9%) patients, located level T8 T12 81.2%. In OR, responsible arteries, including AKA, promptly reconstructed 66 (64.7%) patients. EVR, 65 (42.2%) had covered by an prosthesis. Deaths prior 30 days occurred seven (2.7%, four three EVR) SCI six (5.9%) (2.9%) paraplegia paraparesis, whereas ten (6.5%) SCI, two (1.3%) eight (5.2%) paraparesis. The significantly higher than those without it [13.8% (9 65) vs. 1.1% (1 89); P=0.002], no significant differences found or reconstructed.Preoperative useful enough determine treatment strategies less likelihood both for pathologies.