Scali ST, et al. - Researchers analyzed all Vascular Quality Initiative thoracic endovascular aortic repair (TEVAR) procedures (2011-18) to assess the survival impact of spinal cord ischemia (SCI) with or without in-hospital recovery, and develop a preoperative SCI prediction tool for patients undergoing TEVAR. This analysis has been identified as the first description of a preoperative prediction tool derived from national data for determining SCI risk after TEVAR. SCI was observed in 4.7% of cases (n = 436 of 9217 patients). Following TEVAR, SCI is a devastating complication that has a notable impact on overall survival, especially when no functional recovery occurs by time of hospital discharge. Acute dissection (6.6%), intramural hematoma (6.4%), traumatic transection (5%), chronic dissection (4.6%), aortic thrombus (4.5%), degenerative aneurysm (4.2%), and penetrating aortic ulcer/intramural hematoma (3.2%) were the pathologic specific incidence of any SCI. Factors selected as the most important independent preoperative predictors of SCI were American Society of Anesthesiology class (per level), prior aortic/infrainguinal bypass, nonelective case, hypertension, chronic obstructive pulmonary disease, preoperative creatinine > 1.78 mg/dL, use of intravascular ultrasound examination, female gender, non-white race, max aneurysm diameter per mm increase, age per year increase.