Delayed bridging stent placement for rescue of spinal cord ischemia during complex endovascular repair of thoracoabdominal aortic aneurysms

Spinal cord ischemia remains a significant cause of patient morbidity in the repair of thoracoabdominal aortic aneurysms. We present a three-case series of delayed bridging stent placement in patients who had significant neuromonitoring changes during index aneurysm repair. To prevent spinal cord is...

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Main Authors: Michael H. Parker, MD, Michael C. Soult, MD, Carlos F. Bechara, MD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468428725000462
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author Michael H. Parker, MD
Michael C. Soult, MD
Carlos F. Bechara, MD
author_facet Michael H. Parker, MD
Michael C. Soult, MD
Carlos F. Bechara, MD
author_sort Michael H. Parker, MD
collection DOAJ
description Spinal cord ischemia remains a significant cause of patient morbidity in the repair of thoracoabdominal aortic aneurysms. We present a three-case series of delayed bridging stent placement in patients who had significant neuromonitoring changes during index aneurysm repair. To prevent spinal cord ischemia, we delayed placement of the final bridging stent in each case for 4 to 8 weeks. The final stent was then placed under local anesthesia with the patient moving their lower extremities throughout the procedure and a 10- to 15-minute balloon occlusion test to ensure adequate spinal perfusion. All patients tolerated the procedure well without evidence of spinal cord ischemia.
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series Journal of Vascular Surgery Cases and Innovative Techniques
spelling doaj-art-3b15956f3ec043db9f0271a4e47339ef2025-08-20T02:57:21ZengElsevierJournal of Vascular Surgery Cases and Innovative Techniques2468-42872025-06-0111310176410.1016/j.jvscit.2025.101764Delayed bridging stent placement for rescue of spinal cord ischemia during complex endovascular repair of thoracoabdominal aortic aneurysmsMichael H. Parker, MD0Michael C. Soult, MD1Carlos F. Bechara, MD2Division of Vascular Surgery and Endovascular Therapy, University of Vermont Medical Center, Burlington, VT; Correspondence: Michael H. Parker, MD, University of Vermont Medical Center, 111 Colchester Ave, MP 5, Burlington, VT 05401Division of Vascular Surgery, Loyola University Medical Center, Maywood, ILDivision of Vascular Surgery, Loyola University Medical Center, Maywood, IL; Department of Vascular and Endovascular Surgery, Rush University Medical Center, Chicago, ILSpinal cord ischemia remains a significant cause of patient morbidity in the repair of thoracoabdominal aortic aneurysms. We present a three-case series of delayed bridging stent placement in patients who had significant neuromonitoring changes during index aneurysm repair. To prevent spinal cord ischemia, we delayed placement of the final bridging stent in each case for 4 to 8 weeks. The final stent was then placed under local anesthesia with the patient moving their lower extremities throughout the procedure and a 10- to 15-minute balloon occlusion test to ensure adequate spinal perfusion. All patients tolerated the procedure well without evidence of spinal cord ischemia.http://www.sciencedirect.com/science/article/pii/S2468428725000462Thoracoabdominal aortic aneurysmEndovascular aneurysm repairFenestrated endovascular aneurysm repairSpinal cord ischemiaCase reports
spellingShingle Michael H. Parker, MD
Michael C. Soult, MD
Carlos F. Bechara, MD
Delayed bridging stent placement for rescue of spinal cord ischemia during complex endovascular repair of thoracoabdominal aortic aneurysms
Journal of Vascular Surgery Cases and Innovative Techniques
Thoracoabdominal aortic aneurysm
Endovascular aneurysm repair
Fenestrated endovascular aneurysm repair
Spinal cord ischemia
Case reports
title Delayed bridging stent placement for rescue of spinal cord ischemia during complex endovascular repair of thoracoabdominal aortic aneurysms
title_full Delayed bridging stent placement for rescue of spinal cord ischemia during complex endovascular repair of thoracoabdominal aortic aneurysms
title_fullStr Delayed bridging stent placement for rescue of spinal cord ischemia during complex endovascular repair of thoracoabdominal aortic aneurysms
title_full_unstemmed Delayed bridging stent placement for rescue of spinal cord ischemia during complex endovascular repair of thoracoabdominal aortic aneurysms
title_short Delayed bridging stent placement for rescue of spinal cord ischemia during complex endovascular repair of thoracoabdominal aortic aneurysms
title_sort delayed bridging stent placement for rescue of spinal cord ischemia during complex endovascular repair of thoracoabdominal aortic aneurysms
topic Thoracoabdominal aortic aneurysm
Endovascular aneurysm repair
Fenestrated endovascular aneurysm repair
Spinal cord ischemia
Case reports
url http://www.sciencedirect.com/science/article/pii/S2468428725000462
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AT carlosfbecharamd delayedbridgingstentplacementforrescueofspinalcordischemiaduringcomplexendovascularrepairofthoracoabdominalaorticaneurysms