Spinal Arterial Anatomy and Risk Factors for Lower Extremity Weakness following Endovascular Thoracoabdominal Aortic Aneurysm Repair with Branched Stent-Grafts
Purpose: To evaluate spinal arterial anatomy and identify risk factors for lower extremity weakness (LEW) following endovascular thoracoabdominal aortic aneurysm (TAAA) repair. Methods: A retrospective review was conducted of 37 patients (27 men; mean age 74.8±7.1 years, range 58–86) undergoing endo...
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| Veröffentlicht in: | Journal of endovascular therapy 2008-06, Vol.15 (3), p.356-362 |
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| creator | Chang, Catherine K. Chuter, Timothy A.M. Reilly, Linda M. Ota, Maile K. Furtado, Andre Bucci, Monica Wintermark, Max Hiramoto, Jade S. |
| description | Purpose:
To evaluate spinal arterial anatomy and identify risk factors for lower extremity weakness (LEW) following endovascular thoracoabdominal aortic aneurysm (TAAA) repair.
Methods:
A retrospective review was conducted of 37 patients (27 men; mean age 74.8±7.1 years, range 58–86) undergoing endovascular TAAA repair with branched stent-grafts at a single academic institution from July 2005 to December 2007. Data were collected on preoperative comorbidities, duration of operation, blood loss, type of anesthesia, extent of aortic coverage, blood pressure, cerebrospinal fluid (CSF) pressure and drainage, and postoperative development of LEW. Pre- and postoperative contrast-enhanced computed tomographic angiograms (CTA) in a 26-patient subset were analyzed to evaluate the number of patent intercostal and lumbar arteries before and after repair.
Results:
All patients were neurologically intact at the end of the operation. Seven (19%) patients developed LEW postoperatively: 6 perioperatively and 1 after discharge. LEW was associated with postoperative hypotension, internal iliac artery (IIA) occlusion, and fewer patent segmental arteries on preoperative CTA. Lowest mean systolic blood pressure was |
| doi_str_mv | 10.1583/08-2426.1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71656039</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_08-2426.1</sage_id><sourcerecordid>71656039</sourcerecordid><originalsourceid>FETCH-LOGICAL-c341t-35f49fdd38cc6718a79f5c009cf4b9c859fa11633e46986873edd5328749b6243</originalsourceid><addsrcrecordid>eNplkc9u1DAQxi0EoqVw4AWQxQGJQ4odx45zLNX2j7QSUlvEMZq1na7bxF7GDss-Da9Kol1pJTjNSPPT983MR8h7zs651OIL00VZleqcvyCnXFay4FKyl3NfqkKxUp-QNyk9MVbykvPX5IRrWbGal6fkz_3GB-jpBWaHfm4C5DjsKARL73x6pldgcsREu4h0GbcO6eJ3Rjf4vKM_HDwHl-Zh38etD490EWz8BcmMPSB9WEcEE2Fl47C3iZi9mUzciLs00Du3AY906_OafkUIZu0svc8u5OIaocvpLXnVQZ_cu0M9I9-vFg-XN8Xy2_Xt5cWyMKLiuRCyq5rOWqGNUTXXUDedNIw1pqtWjdGy6YBzJYSrVKOVroWzVopS11WzUmUlzsinve4G48_RpdwOPhnX9xBcHFNbcyUVE80EfvwHfIojTreldvotF3Ut2QR93kMGY0rounaDfgDctZy1c2Qt0-0cWcsn9sNBcFwNzh7JQ0bH1RI8uqPb_0p_AUr_nk4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211137750</pqid></control><display><type>article</type><title>Spinal Arterial Anatomy and Risk Factors for Lower Extremity Weakness following Endovascular Thoracoabdominal Aortic Aneurysm Repair with Branched Stent-Grafts</title><source>SAGE Complete A-Z List</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Chang, Catherine K. ; Chuter, Timothy A.M. ; Reilly, Linda M. ; Ota, Maile K. ; Furtado, Andre ; Bucci, Monica ; Wintermark, Max ; Hiramoto, Jade S.</creator><creatorcontrib>Chang, Catherine K. ; Chuter, Timothy A.M. ; Reilly, Linda M. ; Ota, Maile K. ; Furtado, Andre ; Bucci, Monica ; Wintermark, Max ; Hiramoto, Jade S.</creatorcontrib><description>Purpose:
To evaluate spinal arterial anatomy and identify risk factors for lower extremity weakness (LEW) following endovascular thoracoabdominal aortic aneurysm (TAAA) repair.
Methods:
A retrospective review was conducted of 37 patients (27 men; mean age 74.8±7.1 years, range 58–86) undergoing endovascular TAAA repair with branched stent-grafts at a single academic institution from July 2005 to December 2007. Data were collected on preoperative comorbidities, duration of operation, blood loss, type of anesthesia, extent of aortic coverage, blood pressure, cerebrospinal fluid (CSF) pressure and drainage, and postoperative development of LEW. Pre- and postoperative contrast-enhanced computed tomographic angiograms (CTA) in a 26-patient subset were analyzed to evaluate the number of patent intercostal and lumbar arteries before and after repair.
Results:
All patients were neurologically intact at the end of the operation. Seven (19%) patients developed LEW postoperatively: 6 perioperatively and 1 after discharge. LEW was associated with postoperative hypotension, internal iliac artery (IIA) occlusion, and fewer patent segmental arteries on preoperative CTA. Lowest mean systolic blood pressure was <90 mmHg in all 6 (100%) patients who developed LEW in hospital compared to 12 (44%) of the 27 patients who did not develop LEW (p=0.02). Complete resolution of LEW (n=4) followed prompt measures to raise blood pressure and lower CSF pressure. Persistent LEW (n=3) was associated with sustained hypotension from sepsis, postoperative bleeding, and hemodialysis, respectively. Two (29%) of 7 patients with LEW either lost prograde flow to an IIA during repair or had bilaterally occluded IIAs preoperatively compared to 2 (7%) of 30 patients without LEW (p=0.16). Comparison of pre- and postoperative CTAs showed no reduction in the mean number of patent segmental arteries in patients with or without LEW.
Conclusion:
Endovascular TAAA repair inevitably occludes direct inflow to lumbar and intercostal arteries. The distal segments of these arteries to the spine, however, are seen to remain patent through collaterals. Measures to preserve collateral pathways and increase perfusion pressure may help prevent or treat LEW.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/08-2426.1</identifier><identifier>PMID: 18540712</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Aortic Aneurysm, Thoracic - surgery ; Arteries - pathology ; Arteries - physiopathology ; Awards and Prizes ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation - adverse effects ; Blood Vessel Prosthesis Implantation - instrumentation ; Collateral Circulation ; Female ; Humans ; Intensive care ; Lower Extremity ; Male ; Medical imaging ; Paraparesis - diagnostic imaging ; Paraparesis - etiology ; Paraparesis - physiopathology ; Paraplegia - diagnostic imaging ; Paraplegia - etiology ; Paraplegia - physiopathology ; Patients ; Prosthesis Design ; Retrospective Studies ; Risk Factors ; Sample size ; Spinal Cord Ischemia - diagnostic imaging ; Spinal Cord Ischemia - etiology ; Spinal Cord Ischemia - physiopathology ; Spine - blood supply ; Standard deviation ; Stents ; Tomography, X-Ray Computed ; Vascular Patency ; Veins & arteries</subject><ispartof>Journal of endovascular therapy, 2008-06, Vol.15 (3), p.356-362</ispartof><rights>2008 SAGE Publications</rights><rights>Copyright Alliance Communications Group, A Division of Allen Press, Inc. Jun 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c341t-35f49fdd38cc6718a79f5c009cf4b9c859fa11633e46986873edd5328749b6243</citedby><cites>FETCH-LOGICAL-c341t-35f49fdd38cc6718a79f5c009cf4b9c859fa11633e46986873edd5328749b6243</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1583/08-2426.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1583/08-2426.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,776,780,21798,27901,27902,43597,43598</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18540712$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, Catherine K.</creatorcontrib><creatorcontrib>Chuter, Timothy A.M.</creatorcontrib><creatorcontrib>Reilly, Linda M.</creatorcontrib><creatorcontrib>Ota, Maile K.</creatorcontrib><creatorcontrib>Furtado, Andre</creatorcontrib><creatorcontrib>Bucci, Monica</creatorcontrib><creatorcontrib>Wintermark, Max</creatorcontrib><creatorcontrib>Hiramoto, Jade S.</creatorcontrib><title>Spinal Arterial Anatomy and Risk Factors for Lower Extremity Weakness following Endovascular Thoracoabdominal Aortic Aneurysm Repair with Branched Stent-Grafts</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose:
To evaluate spinal arterial anatomy and identify risk factors for lower extremity weakness (LEW) following endovascular thoracoabdominal aortic aneurysm (TAAA) repair.
Methods:
A retrospective review was conducted of 37 patients (27 men; mean age 74.8±7.1 years, range 58–86) undergoing endovascular TAAA repair with branched stent-grafts at a single academic institution from July 2005 to December 2007. Data were collected on preoperative comorbidities, duration of operation, blood loss, type of anesthesia, extent of aortic coverage, blood pressure, cerebrospinal fluid (CSF) pressure and drainage, and postoperative development of LEW. Pre- and postoperative contrast-enhanced computed tomographic angiograms (CTA) in a 26-patient subset were analyzed to evaluate the number of patent intercostal and lumbar arteries before and after repair.
Results:
All patients were neurologically intact at the end of the operation. Seven (19%) patients developed LEW postoperatively: 6 perioperatively and 1 after discharge. LEW was associated with postoperative hypotension, internal iliac artery (IIA) occlusion, and fewer patent segmental arteries on preoperative CTA. Lowest mean systolic blood pressure was <90 mmHg in all 6 (100%) patients who developed LEW in hospital compared to 12 (44%) of the 27 patients who did not develop LEW (p=0.02). Complete resolution of LEW (n=4) followed prompt measures to raise blood pressure and lower CSF pressure. Persistent LEW (n=3) was associated with sustained hypotension from sepsis, postoperative bleeding, and hemodialysis, respectively. Two (29%) of 7 patients with LEW either lost prograde flow to an IIA during repair or had bilaterally occluded IIAs preoperatively compared to 2 (7%) of 30 patients without LEW (p=0.16). Comparison of pre- and postoperative CTAs showed no reduction in the mean number of patent segmental arteries in patients with or without LEW.
Conclusion:
Endovascular TAAA repair inevitably occludes direct inflow to lumbar and intercostal arteries. The distal segments of these arteries to the spine, however, are seen to remain patent through collaterals. Measures to preserve collateral pathways and increase perfusion pressure may help prevent or treat LEW.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Aneurysm, Thoracic - surgery</subject><subject>Arteries - pathology</subject><subject>Arteries - physiopathology</subject><subject>Awards and Prizes</subject><subject>Blood Vessel Prosthesis</subject><subject>Blood Vessel Prosthesis Implantation - adverse effects</subject><subject>Blood Vessel Prosthesis Implantation - instrumentation</subject><subject>Collateral Circulation</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive care</subject><subject>Lower Extremity</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Paraparesis - diagnostic imaging</subject><subject>Paraparesis - etiology</subject><subject>Paraparesis - physiopathology</subject><subject>Paraplegia - diagnostic imaging</subject><subject>Paraplegia - etiology</subject><subject>Paraplegia - physiopathology</subject><subject>Patients</subject><subject>Prosthesis Design</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Sample size</subject><subject>Spinal Cord Ischemia - diagnostic imaging</subject><subject>Spinal Cord Ischemia - etiology</subject><subject>Spinal Cord Ischemia - physiopathology</subject><subject>Spine - blood supply</subject><subject>Standard deviation</subject><subject>Stents</subject><subject>Tomography, X-Ray Computed</subject><subject>Vascular Patency</subject><subject>Veins & arteries</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNplkc9u1DAQxi0EoqVw4AWQxQGJQ4odx45zLNX2j7QSUlvEMZq1na7bxF7GDss-Da9Kol1pJTjNSPPT983MR8h7zs651OIL00VZleqcvyCnXFay4FKyl3NfqkKxUp-QNyk9MVbykvPX5IRrWbGal6fkz_3GB-jpBWaHfm4C5DjsKARL73x6pldgcsREu4h0GbcO6eJ3Rjf4vKM_HDwHl-Zh38etD490EWz8BcmMPSB9WEcEE2Fl47C3iZi9mUzciLs00Du3AY906_OafkUIZu0svc8u5OIaocvpLXnVQZ_cu0M9I9-vFg-XN8Xy2_Xt5cWyMKLiuRCyq5rOWqGNUTXXUDedNIw1pqtWjdGy6YBzJYSrVKOVroWzVopS11WzUmUlzsinve4G48_RpdwOPhnX9xBcHFNbcyUVE80EfvwHfIojTreldvotF3Ut2QR93kMGY0rounaDfgDctZy1c2Qt0-0cWcsn9sNBcFwNzh7JQ0bH1RI8uqPb_0p_AUr_nk4</recordid><startdate>200806</startdate><enddate>200806</enddate><creator>Chang, Catherine K.</creator><creator>Chuter, Timothy A.M.</creator><creator>Reilly, Linda M.</creator><creator>Ota, Maile K.</creator><creator>Furtado, Andre</creator><creator>Bucci, Monica</creator><creator>Wintermark, Max</creator><creator>Hiramoto, Jade S.</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200806</creationdate><title>Spinal Arterial Anatomy and Risk Factors for Lower Extremity Weakness following Endovascular Thoracoabdominal Aortic Aneurysm Repair with Branched Stent-Grafts</title><author>Chang, Catherine K. ; Chuter, Timothy A.M. ; Reilly, Linda M. ; Ota, Maile K. ; Furtado, Andre ; Bucci, Monica ; Wintermark, Max ; Hiramoto, Jade S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c341t-35f49fdd38cc6718a79f5c009cf4b9c859fa11633e46986873edd5328749b6243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Aneurysm, Thoracic - surgery</topic><topic>Arteries - pathology</topic><topic>Arteries - physiopathology</topic><topic>Awards and Prizes</topic><topic>Blood Vessel Prosthesis</topic><topic>Blood Vessel Prosthesis Implantation - adverse effects</topic><topic>Blood Vessel Prosthesis Implantation - instrumentation</topic><topic>Collateral Circulation</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive care</topic><topic>Lower Extremity</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Paraparesis - diagnostic imaging</topic><topic>Paraparesis - etiology</topic><topic>Paraparesis - physiopathology</topic><topic>Paraplegia - diagnostic imaging</topic><topic>Paraplegia - etiology</topic><topic>Paraplegia - physiopathology</topic><topic>Patients</topic><topic>Prosthesis Design</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Sample size</topic><topic>Spinal Cord Ischemia - diagnostic imaging</topic><topic>Spinal Cord Ischemia - etiology</topic><topic>Spinal Cord Ischemia - physiopathology</topic><topic>Spine - blood supply</topic><topic>Standard deviation</topic><topic>Stents</topic><topic>Tomography, X-Ray Computed</topic><topic>Vascular Patency</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Catherine K.</creatorcontrib><creatorcontrib>Chuter, Timothy A.M.</creatorcontrib><creatorcontrib>Reilly, Linda M.</creatorcontrib><creatorcontrib>Ota, Maile K.</creatorcontrib><creatorcontrib>Furtado, Andre</creatorcontrib><creatorcontrib>Bucci, Monica</creatorcontrib><creatorcontrib>Wintermark, Max</creatorcontrib><creatorcontrib>Hiramoto, Jade S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Catherine K.</au><au>Chuter, Timothy A.M.</au><au>Reilly, Linda M.</au><au>Ota, Maile K.</au><au>Furtado, Andre</au><au>Bucci, Monica</au><au>Wintermark, Max</au><au>Hiramoto, Jade S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Spinal Arterial Anatomy and Risk Factors for Lower Extremity Weakness following Endovascular Thoracoabdominal Aortic Aneurysm Repair with Branched Stent-Grafts</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2008-06</date><risdate>2008</risdate><volume>15</volume><issue>3</issue><spage>356</spage><epage>362</epage><pages>356-362</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose:
To evaluate spinal arterial anatomy and identify risk factors for lower extremity weakness (LEW) following endovascular thoracoabdominal aortic aneurysm (TAAA) repair.
Methods:
A retrospective review was conducted of 37 patients (27 men; mean age 74.8±7.1 years, range 58–86) undergoing endovascular TAAA repair with branched stent-grafts at a single academic institution from July 2005 to December 2007. Data were collected on preoperative comorbidities, duration of operation, blood loss, type of anesthesia, extent of aortic coverage, blood pressure, cerebrospinal fluid (CSF) pressure and drainage, and postoperative development of LEW. Pre- and postoperative contrast-enhanced computed tomographic angiograms (CTA) in a 26-patient subset were analyzed to evaluate the number of patent intercostal and lumbar arteries before and after repair.
Results:
All patients were neurologically intact at the end of the operation. Seven (19%) patients developed LEW postoperatively: 6 perioperatively and 1 after discharge. LEW was associated with postoperative hypotension, internal iliac artery (IIA) occlusion, and fewer patent segmental arteries on preoperative CTA. Lowest mean systolic blood pressure was <90 mmHg in all 6 (100%) patients who developed LEW in hospital compared to 12 (44%) of the 27 patients who did not develop LEW (p=0.02). Complete resolution of LEW (n=4) followed prompt measures to raise blood pressure and lower CSF pressure. Persistent LEW (n=3) was associated with sustained hypotension from sepsis, postoperative bleeding, and hemodialysis, respectively. Two (29%) of 7 patients with LEW either lost prograde flow to an IIA during repair or had bilaterally occluded IIAs preoperatively compared to 2 (7%) of 30 patients without LEW (p=0.16). Comparison of pre- and postoperative CTAs showed no reduction in the mean number of patent segmental arteries in patients with or without LEW.
Conclusion:
Endovascular TAAA repair inevitably occludes direct inflow to lumbar and intercostal arteries. The distal segments of these arteries to the spine, however, are seen to remain patent through collaterals. Measures to preserve collateral pathways and increase perfusion pressure may help prevent or treat LEW.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>18540712</pmid><doi>10.1583/08-2426.1</doi><tpages>7</tpages></addata></record> |
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| ispartof | Journal of endovascular therapy, 2008-06, Vol.15 (3), p.356-362 |
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| subjects | Aged Aged, 80 and over Aortic Aneurysm, Thoracic - surgery Arteries - pathology Arteries - physiopathology Awards and Prizes Blood Vessel Prosthesis Blood Vessel Prosthesis Implantation - adverse effects Blood Vessel Prosthesis Implantation - instrumentation Collateral Circulation Female Humans Intensive care Lower Extremity Male Medical imaging Paraparesis - diagnostic imaging Paraparesis - etiology Paraparesis - physiopathology Paraplegia - diagnostic imaging Paraplegia - etiology Paraplegia - physiopathology Patients Prosthesis Design Retrospective Studies Risk Factors Sample size Spinal Cord Ischemia - diagnostic imaging Spinal Cord Ischemia - etiology Spinal Cord Ischemia - physiopathology Spine - blood supply Standard deviation Stents Tomography, X-Ray Computed Vascular Patency Veins & arteries |
| title | Spinal Arterial Anatomy and Risk Factors for Lower Extremity Weakness following Endovascular Thoracoabdominal Aortic Aneurysm Repair with Branched Stent-Grafts |
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