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Posterior reversible encephalopathy syndrome from induced hypertension during endovascular thoracoabdominal aortic aneurysm repair  Gustavo S. Oderich,

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Presentation on theme: "Posterior reversible encephalopathy syndrome from induced hypertension during endovascular thoracoabdominal aortic aneurysm repair  Gustavo S. Oderich,"— Presentation transcript:

1 Posterior reversible encephalopathy syndrome from induced hypertension during endovascular thoracoabdominal aortic aneurysm repair  Gustavo S. Oderich, MD, Alexandre A. Pereira, MD, Alejandro A. Rabinstein, MD, Bernardo C. Mendes, MD, Juan N. Pulido, MD  Journal of Vascular Surgery  Volume 61, Issue 4, Pages (April 2015) DOI: /j.jvs Copyright © 2015 Society for Vascular Surgery Terms and Conditions

2 Fig 1 An enlarging 7.2-cm type II thoracoabdominal aortic aneurysm (TAAA) extending from the descending thoracic aorta to the infrarenal abdominal aorta was identified in an 84-year-old patient (A). A TX2 stent graft (Cook Medical, Bloomington, Ind) was modified onsite under strict sterile technique with two mini-cuff reinforced fenestrations for the celiac axis and superior mesenteric artery and two reinforced fenestrations for the renal arteries; the target vessels were bridged with balloon-expandable covered stents (iCast; Atrium Medical, Hudson NH), and self-expandable bare-metal stents were implanted in the celiac artery and superior mesenteric artery due to kinks (B). Follow-up computed tomography angiography at 24-month follow-up demonstrated no endoleak, widely patent fenestrated-branched stent grafts, and aneurysm sac diameter of 45 mm (C). A and B are published by permission of the Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

3 Fig 2 First magnetic resonance imaging (MRI) scan, FLAIR sequence, showing areas of subcortical white matter hyperintensity in both cerebral hemispheres (arrows), with predominance in the left frontal lobe consistent with the focal deficits noted on examination (A and B). These areas did not demonstrate restricted diffusion on the apparent diffusion coefficient map, thus representing vasogenic edema. Second MRI scan, FLAIR sequence, 17 days later showing partial resolution of the previous areas of subcortical white matter hyperintensity indicated by the arrows (C and D). Both scans also demonstrate periventricular white matter changes compatible with chronic ischemia. Journal of Vascular Surgery  , DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

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