Selective Reconstruction of Preoperatively Identified Adamkiewicz Artery During Descending and Thoracoabdominal Aortic Aneurysm Repair; What we have Learned
Paraparesis and paraplegia after repair of the descending (TAA) or thoracoabdominal (TAAA) repair remains devastating complication. The purpose of this study was to determine the effects of selective reconstruction of Adamkiewicz artery (ARM) preoperatively identified with MDCT upon neurological outcome.
Methods: Sixty two consecutive patients who had aneurysms of the descending (n = 15) or thoracoabdominal aorta (n = 47) were studied prospectively with MDCT to identify ARM before and after surgery. Median age was 62 years (29 to 77) and 37 patients had non-dissecting aneurysm and 23 had aortic dissections. The repair was performed and the segmental intercostals arteries (ICA) connected with ARM were reconstructed selectively according to the identification of ARM with MDCT.