Unilateral low extremity paraplegia after thoracic endovascular aortic repair for aortic arch aneurysm

Spinal cord ischemic injury and consequently permanent paraplegia remain the most devastating complications after open and endovascular thoracic or thoracoabdominal aortic aneurysm repair. Hemodynamic stability, which depends on a network of blood vessels around the cord, is most important not only during but also after stent-graft deployment to prevent spinal cord injury. Despite the use of various strategies to prevent spinal cord ischemia, including aggressive revascularization of the subclavian artery and cerebrospinal fluid drainage, this condition remains inevitable and difficult to predict before an operation. We present a rare case of a patient who presented with unilateral paraplegia that developed after thoracic endovascular aortic repair for aortic arch aneurysm and our subsequent salvage strategy