Aorta/TAAA

Question 1

What is an Extent I TAAA

Answer 1

L SCA to celiac axis (suprarenal)

Question 2

What is an Extent II TAAA

Answer 2

L SCA to aortic bifurcation (most extensive)

Question 3

What is an Extent III TAAA

Answer 3

6th intercostal space to aortic bifurcation

Question 4

What is an Extent IV TAAA

Answer 4

Visceral aorta to aortic bifurcation (does not involve thoracic aorta)

Question 5

What is an Extent V TAAA

Answer 5

6th intercostal space to above renal arteries (suprarenal)

Question 6

What is the threshold for surgical intervention in an intact TAAA?

Answer 6

5.5cm

If high risk factors, can consider repair at <5.5cm

Question 7

What are risk factors for TAAA rupture?

Answer 7

• Rapid growth (>0.5cm/year)
• Symptomatic
• Connective tissue disease
• Saccular aneurysm
• Infectious aneurysm
• Female

Question 8

Goal spinal cord perfusion pressure during TAAA repair

Answer 8

SCPP >70mmHg

Question 9

What percentage of SCI after TAAA repair is due to delayed paraplegia?

Answer 9

Up to 60% (may occur any time in the first 2 weeks after surgery)

Question 10

What Extent aneurysms require lung isolation for repair?

Answer 10

Extent I, II and III

Question 11

What is the incidence of SCI in open TAAA repair?

Answer 11

3.4% (double this if Extent II)

Question 12

What is the incidence of SCI in TEVARs?

Answer 12

2.1% incidence of permanent deficit

Question 13

Which aortic zone includes the origin of the Artery of Adamkiewicz?

Answer 13

Zone 5 (T9-T12)

Question 14

What is the equation for spinal cord perfusion pressure?

Answer 14

MAP - ICP or CVP (whichever is greater)

Question 15

What is the one SCI prevention that is supported by strong data?

Answer 15

CSF drainage

Question 16

What are the complication rates for lumbar drains (all complications and serious complications)?

Answer 16

All complications: 7%
Serious complications: 4%

However, CSF drainage has decreased SCI complications from 13% to 2.6% in open Extent I and II repairs.