Association between False Lumen Origin of Segmental Arteries and Postoperative Spinal Cord Injury in Acute Type A Aortic Dissection.

PURPOSE: We examined whether false lumen-origin segmental arteries (SAs) were associated with postoperative spinal cord injury (SCI) after surgery for acute Stanford type A aortic dissection (ATAAD).

METHODS

We reviewed 201 consecutive patients who underwent open repair for ATAAD between January 2008 and February 2026. After prespecified exclusions, 124 patients were analyzed, including 83 with evaluable contrast-enhanced computed tomography for detailed SA assessment.

RESULTS

Postoperative SCI occurred in 9 patients (7.3%), who comprised the SCI group; the remaining 115 comprised the non-SCI group. Total arch replacement and frozen elephant trunk use were numerically more frequent in the SCI group. In the detailed cohort, the number of false lumen-origin SAs was higher in the SCI group at T3-T7 (7.2 ± 3.0 vs. 3.9 ± 3.1, P = 0.042) and T8-L2 (10.3 ± 2.7 vs. 5.5 ± 4.2, P = 0.005). The corresponding proportions were also higher at T3-T7 (77.5% vs. 45.2%, P = 0.047) and T8-L2 (75.0% vs. 41.9%, P = 0.010).

CONCLUSION

In this exploratory single-center cohort, false lumen-origin SAs were associated with postoperative SCI in unadjusted analyses. Further studies are needed to determine their value for preoperative risk stratification.