Chronic aortic dissection not a risk factor for neurologic deficit in thoracoabdominal aortic aneurysm repair

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
H J SafiL Maximilian Buja

Abstract

chronic aortic dissection has long been considered a risk factor for neurologic deficit following thoracoabdominal aortic aneurysm (TAA) surgery. We reviewed our experience with regard to aneurysm extent and the use of adjunct, (distal aortic perfusion/cerebrospinal fluid drainage), and examined the impact of these factors on neurologic deficit among chronic dissection and non-dissection cases. between February 1991 and March 2001, we repaired 800 aneurysms of the descending thoracic and thoracoabdominal aorta. Seven hundred and twenty-nine cases were elective; 196 chronic dissection, 533 non-dissection. 182/729 (24.9%) were TAA extent II. Among these, 61/182 (33%) involved chronic dissection. Adjunct was used in 507/729 (69.6%). We conducted detailed multivariate analyses to isolate the impact of chronic aortic dissection on neurologic morbidity, with other important risk factors taken into account. overall, 32/729 (4.4%) patients had neurologic deficit upon awakening; 7/196 (3.6%) in chronic dissections, and 25/533 (4.7%) in non-dissections. Adjunct had a major effect, reducing neurologic deficit in TAA extent II from 10/36 (27.8%) to 10/146 (6.9%) (p=0.001). However, in univariate and multivariate analysis, chronic dissectio...Continue Reading

Citations

Jan 1, 2011·Annals of Vascular Diseases·Kengo NishimuraIwao Taniguchi
Mar 31, 2005·The Annals of Thoracic Surgery·Jorge FloresKeishu Yasuda
Apr 27, 2010·The Annals of Thoracic Surgery·Stefano ZoliRandall B Griepp
Apr 26, 2016·Journal of Vascular Surgery·Jason ConstantinouTara M Mastracci
Dec 11, 2003·The Journal of Thoracic and Cardiovascular Surgery·Anthony L EstreraHazim J Safi
Dec 24, 2011·Seminars in Cardiothoracic and Vascular Anesthesia·Omid JazaeriT Brett Reece
Oct 24, 2017·Asian Cardiovascular & Thoracic Annals·Gilles GodetEdouard Kieffer
Feb 17, 2009·Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia·Dan MarekJan Lukl
May 4, 2004·The British Journal of Surgery·H J Safi, A L Estrera

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