Sudden-Onset Paraplegia and Ischemia of the Lower Extremities from Acute Aortic Occlusion following Type A Acute Dissection

Lei Yu, Tianxiang Gu, Enyi

Abstract

Herein, we report the case of a 51-year-old man who presented with sudden-onset paraplegia and ischemia of lower extremities, with low back pain. CT scanning revealed Type A acute dissection with occlusion of the infrarenal abdominal aorta and bilateral iliac arteries. A lumbar catheter was inserted for cerebrospinal fluid drainage and we repaired Type A aortic dissection with ascending aorta and total arch replacement combined with stent-graft elephant trunk technique by using innominate cannulation and an aorto-femoral bypass. On postoperative day three, ischaemic symptoms including paraplegia totally disappeared and he was discharged from the hospital on postoperative day 44.