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Background <p>Contrast-Induced Encephalopathy (CIE) is a rare complication, most commonly reported after carotid or coronary interventions, possibly due to reporting bias.</p> Case presentation <p>We present a case of CIE following two-debranching thoracic endovascular aortic repair (TEVAR). A 79-year-old man with hypertension, hyperlipidemia, stage 4 chronic kidney disease (CKD), and prior cerebral infarction underwent emergency 2-debranching TEVAR for a ruptured thoracic aortic aneurysm (TAA). A total of 200&#xa0;mL of contrast medium was used pre- and intraoperatively. On postoperative day (POD) 1, the patient remained unconscious despite sedation cessation. Non-contrast brain Computed tomography (CT) showed left hemispheric cerebral edema and high-density areas suggestive of contrast extravasation, raising suspicion for CIE. Conservative management with hydration and supportive care led to gradual recovery, with imaging on POD9 showing near-complete resolution.</p> Conclusions <p>Although rare, CIE should be considered in cases of delayed consciousness recovery after TEVAR, particularly in high-risk patients. Early diagnosis and conservative treatment are essential for good outcomes.</p>

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A case of contrast-induced encephalopathy after thoracic endovascular aortic repair for a ruptured thoracic aortic aneurysm

  • 期刊论文

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  • 发表日期：

    2026年3月5日

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  • Jumpei Tokutome,
  • Yuichiro Kishimoto,
  • Takeshi Onohara,
  • Hiromu Horie,
  • Tsuyoshi Sasami,
  • Rikuto Nii,
  • Naoki Sumi,
  • Nozomi Kishimoto,
  • Kenichi Morimoto,
  • Junya Nakashima,
  • Yasushi Yoshikawa

摘要

Background

Contrast-Induced Encephalopathy (CIE) is a rare complication, most commonly reported after carotid or coronary interventions, possibly due to reporting bias.

Case presentation

We present a case of CIE following two-debranching thoracic endovascular aortic repair (TEVAR). A 79-year-old man with hypertension, hyperlipidemia, stage 4 chronic kidney disease (CKD), and prior cerebral infarction underwent emergency 2-debranching TEVAR for a ruptured thoracic aortic aneurysm (TAA). A total of 200 mL of contrast medium was used pre- and intraoperatively. On postoperative day (POD) 1, the patient remained unconscious despite sedation cessation. Non-contrast brain Computed tomography (CT) showed left hemispheric cerebral edema and high-density areas suggestive of contrast extravasation, raising suspicion for CIE. Conservative management with hydration and supportive care led to gradual recovery, with imaging on POD9 showing near-complete resolution.

Conclusions

Although rare, CIE should be considered in cases of delayed consciousness recovery after TEVAR, particularly in high-risk patients. Early diagnosis and conservative treatment are essential for good outcomes.