Introduction

In 1952, Denton Cooley and Michael DeBakey reported the first successful series of thoracic aortic aneurysm repairs.[1] By the 1970s, thoracic aortic repairs were routinely performed at a small number of centers. As more experience accrued with these procedures, the implications of spinal cord injury became strikingly obvious. In 1978, Crawford published one of the first large series on surgical treatment of thoracoabdominal aortic aneurysms (TAAA) over an 18-year period. In that series, Crawford reported a 28% incidence of paraplegia following extent II repairs.[2]This paper defined both the feasibility of the procedure and its risks, specifically, the impressive rate of paraplegia with the clamp-and-sew technique. Despite nearly 40 years of improvements, however, paraplegia among TAAA repairs persists, with devastating consequences to those afflicted. This complication serves as a constant and humbling reminder to those caring for these patients.