TY - JOUR
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 - 2013/8
Y1 - 2013/8
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 - Aged
KW - Aged, 80 and over
KW - Aortic Dissection/cerebrospinal fluid
KW - Aortic Aneurysm/cerebrospinal fluid
KW - Aortic Rupture/cerebrospinal fluid
KW - Drainage/adverse effects
KW - Endovascular Procedures/adverse effects
KW - Female
KW - Humans
KW - Logistic Models
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Odds Ratio
KW - Proportional Hazards Models
KW - Retrospective Studies
KW - Risk Factors
KW - Spinal Cord Ischemia/etiology
KW - Treatment Outcome
U2 - 10.1177/1538574413495461
DO - 10.1177/1538574413495461
M3 - Journal article
C2 - 23847230
SN - 1538-5744
VL - 47
SP - 415
EP - 422
JO - Vascular and Endovascular Surgery
JF - Vascular and Endovascular Surgery
IS - 6
ER -