Spinal cord ischemia after elective endovascular abdominal aortic aneurysm repair in a patient with multiple occlusions of the intercostal and internal iliac arteries

Spinal cord ischemia (SCI) after endovascular abdominal aortic aneurysm repair is a rare but devastating complication. Occlusion of the artery of Adamkiewicz or feeders to the collateral network for spinal cord circulation (such as the subclavian, intercostal, lumbar, and internal iliac arteries) is associated with the onset of SCI. We present a case of monoplegia owing to SCI after elective endovascular abdominal aortic aneurysm repair with coil embolization of the left internal iliac artery in an elderly patient with a history of arteriosclerosis obliterans and aortic dissection, preoperatively occluding multiple intercostal arteries and the right internal iliac artery.