Paraplegia following surgery of abdominal aortic aneurysm.

We report the case of an 84 year-old man who suffered of paraplegia after s urgery of an abdominal aortic aneurysm. The neurologic status did not impro ve during 5 years of follow-up. This complication is rare in light of the r eview of the literature. II is more frequent after emergency (1.4 %) and re dux (19 %) surgery than after elective surgery (1.1 %). Its mechanisms are anatomic (occlusion of the Adamkievitz artery and of the pelvic collateral arteries) and hemodynamic mechanisms (thromboembolism, low systemic tension , long supra-renal clamping). Since pre-operative aortography to detect ana tomic variations is not realistic, its only prevention remains maintenance of intra-operative hemodynamic, systemic heparinization, and preservation o f the pelvic collateral circulation.