Acute onset of paraplegia after repair of abdominal aortic aneurysm in a patient with acute type B aortic dissection.

We report a rare complication of acute onset paraplegia after repair of an abdominal aortic aneurysm in a patient with acute type B aortic dissection. A 53-year-old man, suffering from abdominal aortic aneurysm (AAA), was admitted to our hospital with type IIIB acute aortic dissection. Ten days after admission, emergency Y-grafting was performed for impending rupture of the AAA. Twenty hours after Y-grafting, weakness of his lower extremities developed and progressed to paraplegia. Enhanced computed tomography scan revealed expansion of a thrombosed false lumen at the thoracoabdominal aorta, resulting in complete obstruction of the true lumen below the infra-renal aorta. Immediate axillobifemoral bypass was performed to prevent lower limb ischemia. Voluntary movement recovered gradually in both legs and eventually the patient could walk independently.