Evaluation of spinal cord ischemia with a retrievable stent graft is useful for determining the type of repair for a case of patch aneurysm.

Patch aneurysms after thoracoabdominal aortic aneurysm repair are a serious late complication. We treated a patient with patch aneurysm (originating at the artery of Adamkiewicz) involving a portion of an implanted graft from a previous operation. First, thoracic endovascular aneurysm repair was planned. A retrievable stent graft was inserted, and motor-evoked potentials were monitored to evaluate spinal cord ischemia. Significant changes in the motor-evoked potentials were observed, and permanent stent graft placement was abandoned. Later, open surgery was performed. The patient showed no postoperative paraplegia and was discharged in good condition.