Covering the intercostal artery branching of the Adamkiewicz artery during endovascular aortic repair increases the risk of spinal cord ischemia

In this study, patients who underwent thoracic endovascular aortic repair (TEVAR) from 2008 to 2022 were enrolled. Stent grafts covered the intercostal artery branching of the Adamkiewicz artery (ICA-AKA) in 108 patients and stent grafts didn’t cover the ICA-AKA in 114 patients. Although covering the ICA-AKA was not a significant risk factor, shaggy aorta, iliac artery access, and procedural time were risk factors for spinal cord ischemia (SCI) in the covered AKA group. No significant risk factors were detected in the uncovered AKA group. Covering the ICA-AKA was not an independent risk for SCI in TEVAR. However, covering the ICA-AKA was indirectly associated with the risk of SCI in patients with shaggy aorta, iliac access, and procedural time.