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Rates of Spinal Cord Infarction After Repair of Aortic Aneurysm or Dissection.

TitleRates of Spinal Cord Infarction After Repair of Aortic Aneurysm or Dissection.
Publication TypeJournal Article
Year of Publication2017
AuthorsGialdini G, Parikh NS, Chatterjee A, Lerario MP, Kamel H, Schneider DB, Navi BB, Murthy SB, Iadecola C, Merkler AE
JournalStroke
Volume48
Issue8
Pagination2073-2077
Date Published2017 Aug
ISSN1524-4628
KeywordsAged, Aged, 80 and over, Aneurysm, Dissecting, Aortic Aneurysm, California, Cohort Studies, Female, Florida, Humans, Infarction, Male, Middle Aged, New York, Postoperative Complications, Retrospective Studies, Spinal Cord Ischemia, Treatment Outcome
Abstract

BACKGROUND AND PURPOSE: The rate of spinal cord infarction (SCI) after surgical or endovascular repair of an aortic aneurysm or dissection is unclear.

METHODS: Using administrative claims data, we identified adult patients discharged from nonfederal acute care hospitals in California, New York, and Florida who underwent surgical or endovascular repair of an aortic aneurysm or dissection between 2005 and 2013. Patients with SCI diagnosed before the aortic repair were excluded. Our primary outcome was an SCI during the index hospitalization for aortic repair. Descriptive statistics were used to estimate crude rates of SCI. Analyses were stratified by whether the aneurysm or dissection had ruptured and by type of repair (surgical versus endovascular).

RESULTS: We identified 91 212 patients who had repair of an aortic aneurysm or dissection. SCI occurred in 235 cases (0.26%; 95% confidence interval [CI], 0.22%-0.29%). In patients with ruptured aneurysm or dissection, the rate of SCI was 0.74% (95% CI, 0.60%-0.88%) compared with 0.16% (95% CI, 0.13%-0.19%) with unruptured aneurysm. In secondary analyses, rates of SCI were similar after endovascular repair (0.91%; 95% CI, 0.62%-1.19%) compared with surgical repair (0.68%; 95% CI, 0.53%-0.83%; P=0.147) of ruptured aortic aneurysm or dissection; however, rates of SCI were higher after surgical repair (0.20%; 95% CI, 0.15%-0.25%) versus endovascular repair (0.11%; 95% CI, 0.08%-0.14%; P<0.001) of unruptured aneurysm.

CONCLUSIONS: SCI occurs in ≈1 in 130 patients undergoing aortic dissection or ruptured aortic aneurysm repair and in 1 in 600 patients undergoing unruptured aortic aneurysm repair.

DOI10.1161/STROKEAHA.117.017071
Alternate JournalStroke
PubMed ID28655811
PubMed Central IDPMC5609505
Grant ListR01 NS100447 / NS / NINDS NIH HHS / United States
K23 NS091395 / NS / NINDS NIH HHS / United States
R01 NS034179 / NS / NINDS NIH HHS / United States
R01 NS095441 / NS / NINDS NIH HHS / United States
R01 NS097443 / NS / NINDS NIH HHS / United States
R37 NS089323 / NS / NINDS NIH HHS / United States
K23 NS082367 / NS / NINDS NIH HHS / United States