Cerebrospinal fluid drainage to prevent paraplegia during thoracic and thoracoabdominal aortic aneurysm surgery: a systematic review and meta-analysis

Cinà, Claudio S.; Abouzahr, Labib; Arena, Goffredo; Laganà, Antonello; Devereaux, P. J.; Farrokhyar, Forough

doi:10.1016/j.jvs.2004.03.017

Cited by 196 publications

(100 citation statements)

References 40 publications

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“… Cerebrospinal fluid drainage (CSFD) which has a strong evidence basis underpinning its use, reducing the pressure of cerebrospinal fluid (CSF) surrounding the spinal cord and consequently increases spinal cord perfusion [2,[18][19] .…”

mentioning

confidence: 99%

A Novel Microwave Sensor to Detect Specific Biomarkers in Human Cerebrospinal Fluid and Their Relationship to Cellular Ischemia During Thoracoabdominal Aortic Aneurysm Repair

et al. 2015

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mentioning

confidence: 99%

A Novel Microwave Sensor to Detect Specific Biomarkers in Human Cerebrospinal Fluid and Their Relationship to Cellular Ischemia During Thoracoabdominal Aortic Aneurysm Repair

et al. 2015

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“…In this case, the cerebrospinal fluid drainage should be suspended. 20 In the present study, all patients submitted to a second treatment for repair of previous leaks and those patients who had been submitted to a previous surgical bypass underwent cerebrospinal fluid monitoring and drainage whenever increases in cerebrospinal fluid pressure levels were detected. In most series and comparisons between endovascular and surgical treatments for Stanford type B aortic dissections, endovascular treatment decreases the incidence of definitive paraplegia.…”

Section: Discussionmentioning

confidence: 91%

Tratamento endovascular da dissecção crônica de aorta tipo B complicada

Metzger¹,

Fontes²,

Novero³

et al. 2012

Rev. Bras. Cardiol. Invasiva

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Background: Endovascular repair of aortic diseases is a well-established therapeutic alternative for patients with the appropriate anatomy and/or high surgical risk, as it provides lower morbidity and mortality rates. This study aimed to analyse the outcomes of asymptomatic patients undergoing endovascular treatment of thoracic aortic dissections with an aortic diameter > 5.5 cm or endoleaks. Technical success, therapeutic success, morbidity, mortality, and perioperative complication and reintervention rates were assessed. Methods: The present retrospective study, which was performed at a reference centre from January, 2010 to July, 2011, analysed consecutive patients undergoing endovascular repair of chronic complicated type B aortic dissections based on the Stanford classification. Results: Twenty-six patients were treated. The mean age was 56.4 ± 7 years, and 61.5% were males. Technical and therapeutic success rates were 100% and 74%, respectively. The perioperative mortality was 7.6%, and the mortality rate in the first year of follow-up was 19.3%. The reintervention rate was 15.3%. Conclusions: In the present study, endovascular treatment of chronic type B aortic dissections proved to be a feasible method associated with acceptable perioperative complication rates. The therapeutic success and reintervention rates indicated the

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“…Multivariate logistic regression analysis revealed that preoperative aortic rupture was a significant independent risk factor of SCI (P=0.002; (10). The benefit of prophylactic CSFD in open aortic surgery has been established by 2 meta-analyses (9,11). In TEVAR, the risk of SCI has not been completely established, with reported incidence rates ranging from 3% to 12% (2,12), and spinal cord-protective protocols are less defined than open aortic surgeries.…”

Section: Risk Factor Analysis For Scimentioning

confidence: 99%

Effects of preemptive cerebrospinal fluid drainage on spinal cord protection during thoracic endovascular aortic repair

Song

Kim

et al. 2017

J. Thorac. Dis.

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Background: Spinal cord injury (SCI) is reported to occur in 3-12% of thoracic endovascular aortic repair (TEVAR) cases, but is a potentially preventable complication of TEVAR for thoracoabdominal pathologies.Although many strategies have been devised to reduce the incidence of SCI, the effectiveness of prophylactic cerebrospinal fluid drainage (CSFD) and left subclavian artery (LSA) revascularization remains controversial.Methods: From 2012 to 2014, 162 patients underwent TEVAR at a single institution. We prospectively collected and retrospectively reviewed the data of 81 patients who underwent preoperative CSFD among the 162 patients. LSA revascularization was routinely used when LSA need to be covered. Preoperative characteristics, intraoperative variables, and outcomes were analyzed.Results: The mean (SD) age of the patients was 60.6 (12.5) years, and 57 patients (70%) were male.Twenty-five patients (31%) presented with degenerative aneurysm; 48 (59%), type B dissection; 5, (6%) penetrating aortic ulcer; and 3 (4%), intramural hematoma. Thirty-six patients (44%) underwent LSA revascularization before TEVAR. Two (2.5%) of the patients who underwent preoperative CSFD had SCI, of whom one recovered ambulatory status at discharge after hypertensive therapy and another had a permanent disability. Prior abdominal aortic aneurysm (AAA) repair tended to relate to SCI (P=0.065), and preoperative aortic rupture was a significant independent risk factor of SCI (P=0.002).Conclusions: Preemptive CSFD as an adjunctive procedure to TEVAR proved to be more effective than selective use of CSFD in other prior reports of SCI cases. Preoperative CSFD is recommended as a prophylactic procedure in patients at high risk of SCI during TEVAR.

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Cerebrospinal fluid drainage to prevent paraplegia during thoracic and thoracoabdominal aortic aneurysm surgery: a systematic review and meta-analysis

Abstract: Evidence from randomized and nonrandomized trials and from cohort studies support the use of CSF drainage as an adjunct to prevent paraplegia when this adjunct is used in centers with large experience in the management of TAAA.

Cited by 196 publications

References 40 publications

A Novel Microwave Sensor to Detect Specific Biomarkers in Human Cerebrospinal Fluid and Their Relationship to Cellular Ischemia During Thoracoabdominal Aortic Aneurysm Repair

A Novel Microwave Sensor to Detect Specific Biomarkers in Human Cerebrospinal Fluid and Their Relationship to Cellular Ischemia During Thoracoabdominal Aortic Aneurysm Repair

Tratamento endovascular da dissecção crônica de aorta tipo B complicada

Effects of preemptive cerebrospinal fluid drainage on spinal cord protection during thoracic endovascular aortic repair

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