Paraplegia after surgery of the suprarenal aorta (26 cases reported during a national survey)
Pillet, J.; Enon, B.; Lescalie, F.; Reigner, B.; Mercier, P.
Journal de Chirurgie 129(10): 426-432
1992
ISSN/ISBN: 0021-7697 PMID: 1294584 Document Number: 391919
Although their frequency is probably underestimated, medullary complications of abdominal aorta surgery are rare but serious, and may be the cause of medico-legal actions. Referral of a patient allowed the collection of 26 unpublished cases: 18 with aneurysms, including 6 ruptured lesions and 12 undergoing cold surgery, and 8 with aorto-iliac occlusion, these 26 cases representing 0.16% of abdominal aorta interventions performed during the same period. Mortality (6 cases) was due principally to neurological complications, total in 4 cases, partial in 3 and persistent in 13. Risk factors were perioperative collapse (explaining the elevated frequency in ruptured aneurysms) and the occlusion of the internal iliac arteries. Duration of clamping was not significant. No certain method of prevention could be elucidated, either by a literature review or by analysis of the personal series.