Complications to Cerebrospinal Fluid Drainage and Predictors of Spinal Cord Ischemia in Patients With Aortic Disease Undergoing Advanced Endovascular Therapy

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Complications to Cerebrospinal Fluid Drainage and Predictors of Spinal Cord Ischemia in Patients With Aortic Disease Undergoing Advanced Endovascular Therapy. / Mehmedagic, Irma; Resch, Timothy; Acosta, Stefan.

I: Vascular and Endovascular Surgery, Vol. 47, Nr. 6, 2013, s. 415-422.

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T1 - Complications to Cerebrospinal Fluid Drainage and Predictors of Spinal Cord Ischemia in Patients With Aortic Disease Undergoing Advanced Endovascular Therapy

AU - Mehmedagic, Irma

AU - Resch, Timothy

AU - Acosta, Stefan

PY - 2013

Y1 - 2013

N2 - Objective: To study the complications after cerebrospinal fluid (CSF) drainage and predictors of spinal cord ischemia (SCI) after advanced endovascular therapy with CSF drainage for complex aortic disease. Methods: Between 2009 and 2012, 88 attempts of CSF drainage insertions/84 operations/83 patients, of the 658 operations for aortoiliac diseases, were performed. Results: Indications for therapy were aortic dissection (n = 13) and aortic aneurysm (n = 70), of whom 38 had thoracoabdominal aortic aneurysm (TAAA). In all, 10 had ruptured aorta. The CSF drainages were inserted preoperatively (n = 75) and postoperatively (n = 9). In all, 14 CSF drainages were nonfunctioning. The SCI was present in 29 patients, transient/permanent in 12/17. Intraoperative circulatory instability (P = .001) and operation for TAAA, type II (P = .036), were associated with SCI. Meningitis (n = 1), epidural (n = 1), and subdural (n = 2) hematoma and needle-mediated paresis in 1 leg (n = 1) occurred after CSF drainage. Conclusions: Complication to CSF drainage occurred too frequently in this selected group of patients with high rate of SCI.

AB - Objective: To study the complications after cerebrospinal fluid (CSF) drainage and predictors of spinal cord ischemia (SCI) after advanced endovascular therapy with CSF drainage for complex aortic disease. Methods: Between 2009 and 2012, 88 attempts of CSF drainage insertions/84 operations/83 patients, of the 658 operations for aortoiliac diseases, were performed. Results: Indications for therapy were aortic dissection (n = 13) and aortic aneurysm (n = 70), of whom 38 had thoracoabdominal aortic aneurysm (TAAA). In all, 10 had ruptured aorta. The CSF drainages were inserted preoperatively (n = 75) and postoperatively (n = 9). In all, 14 CSF drainages were nonfunctioning. The SCI was present in 29 patients, transient/permanent in 12/17. Intraoperative circulatory instability (P = .001) and operation for TAAA, type II (P = .036), were associated with SCI. Meningitis (n = 1), epidural (n = 1), and subdural (n = 2) hematoma and needle-mediated paresis in 1 leg (n = 1) occurred after CSF drainage. Conclusions: Complication to CSF drainage occurred too frequently in this selected group of patients with high rate of SCI.

KW - endovascular therapy

KW - thoracoabdominal aortic aneurysm

KW - cerebrospinal

KW - fluid drainage

KW - spinal cord ischemia

U2 - 10.1177/1538574413495461

DO - 10.1177/1538574413495461

M3 - Article

VL - 47

SP - 415

EP - 422

JO - Vascular Surgery

JF - Vascular Surgery

SN - 1938-9116

IS - 6

ER -