Ischemia-induced lower extremity neurologic impairment after fenestrated endovascular aneurysm repair.

摘要: Abstract Objective Placement of large sheaths in the iliac system during fenestrated endovascular aneurysm repair (FEVAR) leads to lower extremity (LE) ischemia that can be associated with serious neurologic complications. We sought determine effect LE ischemic time on impairment after FEVAR. Methods Consecutive patients who underwent FEVAR at a single institution were analyzed. was calculated from sheath (≥18F) insertion removal arteries led continuous ischemia. The primary outcome defined as any new sensory or motor deficit either LE. Outcomes analyzed using descriptive statistics and modeled logistic regression interaction terms. Each individual used unit analysis. Results examined 101 (202 extremities) over 5-year period. median 2.75 hours (range, 0.8-5.2 hours). Neurologic developed 18 extremities (9%). Of those, 12 (67%) mild loss, 6 (33%) complete 4 (22%) loss proprioception, 2 (11%) dysfunction. Sensory permanent four limbs (2%) dysfunction one limb (0.5%). In all other cases, examination returned baseline by postoperative day 15. Duration (odds ratio, 6.3; 95% confidence interval, 3.1-12.4; P  Conclusions is strongly CIA occlusive disease lumen 8 mm less. Our data indicate that, when expected exceed 2.5 hours (in stenosis) 3 hours without stenosis), measures ensure perfusion should given consideration.