Development of stroke-induced quadriplegia after endovascular repair of blunt aortic injury pseudoaneurysm

• Published in: Neurosciences (Riyadh, Saudi Arabia) Saudi Arabia), 2015-01, Vol.20 (1), p.52-54
• Main Authors: Amoudi, Abdullah S, Merdad, Anas A, Makhdoom, Ahmed Q, Jamjoom, Reda A
• Format: Article
• Language: English
• Subjects: Aneurysm, False - diagnosis; Aneurysm, False - surgery; Aorta, Thoracic - surgery; Case Report; Endovascular Procedures; Humans; Male; Middle Aged; Quadriplegia - diagnosis; Quadriplegia - etiology; Stroke - complications; Subclavian Artery - surgery; Treatment Outcome
• ISSN: 1319-6138

Endovascular repair of blunt aortic injury is now a first-line approach in management. This can warrant coverage of the left subclavian artery (LSA), which could lead to posterior strokes. In this case report, we present a severe complication of endovascular repair of a traumatic aortic aneurysm. A 53-year-old man presented with blunt aortic injury, endovascular repair was carried out where the left subclavian artery was covered. The intervention had a 100% technical success. Twelve hours later, he was discovered to have quadriplegia, a CT scan showed a large left cerebellar infarction extending to the medulla oblongata and proximal spinal cord. Strokes complicate 3% of thoracic endovascular aortic repairs, 80% of those strokes occur in patients who had their LSA`s covered. Most patients however, tolerate the coverage. Although our patient had a dominant right vertebral artery, and lacked risks for these strokes, he developed an extensive stroke that left him quadriplegic.