Spinal cord ischemia prevention and management in thoracoabdominal branched endovascular aortic repair.

Spinal cord ischemia (SCI) is the most feared complication of complex aortic surgery owing to significant morbidity, decreased patient quality of life, and increased risk of overall short- and long-term mortality. As endovascular repair of thoracoabdominal aortic aneurysms (TAAAs) has evolved to become a first-line therapy owing to decreased perioperative complications and mortality when compared to open surgical repair, a focus on prevention and rescue of SCI has become a primary concern. This review describes the background, incidence, risk factors, prevention, and treatment of SCI following branched endovascular aortic repair of TAAAs.