| A Case of Abdominal Aortic Aneurysm
Associated with Postoperative Paraplegia |
(Department of Cardiovascular Surgery, Jikei University
Kashiwa Hospital, Chiba, Japan and Department of Cardiovascular
Surgery, Jikei University School of Medicine*, Tokyo, Japan)
| Motohiro Oshiumi |
Shinichi Ishii |
Hirokuni Naganuma |
| Makoto Sumi |
Kazuhiro Hashimoto* |
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We present a very rare case of abdominal
aortic aneurysm associated with paraplegia. A 68-year-old man
developed paraplegia following resection of a infrarenal abdominal
aortic aneurysm. The aorta was clamped just below the renal arteries.
In this case interruption of the radicular artery magna (RAM;
Adamkiewicz artery) might have caused serious ischemia of the
spinal cord. Spinal cord ischemia is a very rare and unpredictable
complication in surgery of infrarenal abdominal aortic aneurysms
because the spinal cord is generally protected from irreversible
ischemia during infrarenal aortic occlusion by the presence of
the RAM which arises above the renal artery (Even if RAM interruption
might arise, the lower renal artery, and other radicular arteries
are usually present above the renal arteries). We feel that reducing
aortic cross-clamping time as short as possible and avoiding
intra- and postoperative hypotensive episodes to keep adequate
blood flow of collaterals seem to be the most important factors
to prevent spinal cord ischemia.
Jpn. J. Cardiovasc. Surg. 32: 362 -365(2003) |
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