Spinal cord ischemia. Spinal cord ischemia is thought to result from the interruption of the blood supply to the spinal cord, which may occur during deployment of the stent graft. (See Spinal cord ischemia risk fac- tors.) An endovascular approach may damage the iliac arteries
and compromise collateral flow to the anterior spinal artery.9
The incidence of spinal cord ischemia ranges from 2.5% up to 8% and remains a concern.2
Several factors may increase the risk of spinal cord ischemia.9
Most patients who develop spinal cord ischemia will do so within 24 hours of the procedure, with a median onset of 10 to 13 hours.
Preventive strategies include maintenance of mean arterial pressure (MAP), the prevention of high intrathecal pressure through the use of lumbar drains, and the avoidance of high central venous pressures.