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Vasc Endovascular Surg. 2017 Oct;51(7):517-520. doi: 10.1177/1538574417725238. Epub 2017 Aug 18.

Reversal of Spinal Cord Ischemia Following Endovascular Thoracic Aortic Aneurysm Repair With Hyperbaric Oxygen and Therapeutic Hypothermia.

Author information

1
1 Division of Aerospace Medicine, Department of Internal Medicine, Wright State University, Dayton, OH, USA.
2
2 Division of Critical Care Medicine, Department of Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA.
3
3 The University of Texas Medical Branch at Galveston, Galveston, TX, USA.
4
4 University General Hospital, Houston, TX, USA.
5
5 Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA.
6
6 University Vascular Associates, Los Angeles, CA, USA.

Abstract

BACKGROUND:

Neurological adverse events with spinal cord ischemia (SCI) remain one of the most feared complications in patients undergoing thoracic endovascular aortic repair (TEVAR). These patients can develop irreversible paraplegia with lifelong consequences with physical and psychological agony.

CASE PRESENTATION:

We herein present a patient who developed SCI with bilateral lower leg paraplegia on the third postoperative day following TEVAR. Spinal catheter was inserted for spinal fluid drainage. A hyperbaric oxygen therapy was initiated for 90 minutes for 2 days, which was followed by therapeutic hypothermia for 24 hours with a target temperature of 33°C. The patient exhibited significant neurological recovery following these treatments, and he ultimately regained full neurological function without spinal deficit.

DISCUSSION:

This represents the first reported case of full neurological recovery of a patient who developed complete SCI following TEVAR procedure. The neurological recovery was due in part to immediate therapeutic hypothermia and hyperbaric oxygen therapy which reversed the spinal ischemia.

KEYWORDS:

hyperbaric oxygen; paralysis; spinal cord ischemia; therapeutic hypothermia; thoracic endovascular aneurysm repair

PMID:
28820047
DOI:
10.1177/1538574417725238
[Indexed for MEDLINE]

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