Objective:To retrospectively analyse perioperative risk factors of early paraplegia in patients with Stanford type A aortic dissection undergoing Sun's procedure.Methods:All patients who underwent Sun's proce-dure from January to December 2021 in Tongji Hospital were retrospectively analysed.There were 178 patients with 140 males and 38 females at a mean age of(51.5±10.7)years,and 7 patients(3.9％)of them developed postoperative paraplegia.We performed a statistical analysis of perioperative clinical data between the paraplegia and non-paraplegia groups.The locations of the Th7-Th12 intercostal arteries'origin and blood supply were also recorded to investigate the cause of early paraplegia.Results:Among the 178 patients,there were no statistical differences in gender,height,weight,history,aortic crossclamping time,moderate hypothermic circulatory ar-rest time(antegrade cerebral perfusion)and anal temperature between the paraplegia group and non-paraplegia group.Preoperative hypotension events and age had statistically significant differences between the two groups(both P＜0.05).Hounsfield ratio(HUR)from Th7 to Th11 showed statistical differences between the two groups(P＜0.05).Logistic regression analysis suggested that preoperative hypotension(OR=33.80,P＜0.05),the number of stent-covered intercostal arteries ≥8(OR=35.00,P＜0.05),and the number of intercostal arter-ies from false lumen ≥10(OR=36.71,P＜0.05)increased the risk of postoperative paraplegia.Conclusion:Pre-operative hypotension,covered intercostal artery ≥8,and intercostal arteries from false lumen ≥10 may be risk factors for postoperative paraplegia in Stanford type A aortic dissection.HUR has a certain guiding significance in evaluating the blood supply of the residual intercostal artery.
Stanford type A aortic dissectionparaplegiaspinal cord ischemiaHounsfield ratio
NETL
NSTL
万方数据
