Journal of Vascular Surgery
Volume 48, Issue 4 , Pages 836-840 , October 2008

Strategies to improve spinal cord ischemia in endovascular thoracic aortic repair: Outcomes of a prospective cerebrospinal fluid drainage protocol

Presented at the Peripheral Vascular Surgery Society Meeting, Baltimore, Md, Jun 7-9, 2007.

Received 30 January 2008 ,Accepted 27 May 2008.

References 

  1. Stone DH, Brewster DC, Kwolek CJ, LaMuraglia GM, Conrad MF, Chung TK, et al. Stent-graft versus open-surgical repair of the thoracic aorta: mid-term results. J Vasc Surg. 2006;44:1188–1197
  2. Makaroun MS, Dillavou ED, Kee ST, Sicard G, Chaikof E, Bavaria J, et al. Endovascular treatment of thoracic aortic aneurysms: results of the phase II multicenter trial of the GORE TAG thoracic endoprosthesis. J Vasc Surg. 2005;41:1–9
  3. Bavaria JE, Appoo JJ, Makaroun MS, Verter J, Yu Z, Michell RS. Endovascular stent grafting versus open repair of descending thoracic aortic aneurysms in low risk patients: a multicenter comparative trial. J Thorac Cardiovasc Surg. 2007;133:369–377
  4. Sullivan TM, Sundt TM. Complications of thoracic aortic endografts: spinal cord ischemia and stroke. J Vasc Surg. 2006;43(Suppl):85A–88
  5. Carroccio A, Marin M, Ellozy S, Hollier LH. Pathophysiology of paraplegia following endovascular thoracic aortic aneurysm repair. J Card Surg. 2003;18:359–366
  6. Khoynezhad A, Donayre CE, Bui H, Kopchok GE, Walot I, White RA. Risk factors of neurologic deficit after thoracic aortic endografting. Ann Thorac Surg. 2007;83:S882–S889
  7. Chiesa R, Melissano G, Marrocco-Trischitta M, Civilini E, Setacci F. Spinal cord ischemia after elective stent-graft repair of the thoracic aorta. J Vasc Surg. 2005;42:11–17
  8. Cheung AT, Pochettino A, McGarvey ML, Appoo JJ, Fairman RM, Carpenter JP, et al. Strategies to manage paraplegia risk after endovascular stent repair of descending thoracic aortic aneurysms. Ann Thorac Surg. 2005;80:1280–1289
  9. Weigang E, Hartert M, Siegenthaler MP, Beckmann NA, Sircar R, Szabo G, et al. Perioperative management to improve neurologic outcome in thoracic or thoracoabdominal aortic stent-grafting. Ann Thorac Surg. 2006;82:1679–1687
  10. Fuchs RJ, Lee WA, Christoph SN. Transient paraplegia after stent grafting of a descending thoracic aortic aneurysm treated with cerebrospinal fluid drainage. J Clin Anesth. 2003;15:59–63
  11. Ortiz-Gomez JR, Gonzalez-Solis FJ, Fernandez-Alonso L, Bilbao JI. Reversal of acute paraplegia with cerebrospinal fluid drainage after endovascular thoracic aortic aneurysm repair. Anesthesiology. 2001;95:1288–1289
  12. Baril DT, Carroccio A, Ellozy SH, Palchik E, Addis MD, Jacobs TS, et al. Endovascular thoracic aortic repair and previous or concomitant abdominal aortic repair: is the increased risk of spinal cord ischemia real?. Ann Vasc Surg. 2006;20:188–194
  13. Schurink GWH, Nijenhus RJ, Backes WH, Mess W, de Haan MW, Mochtar B, et al. Assessment of spinal cord circulation and function in endovascular treatment of thoracic aortic aneurysm. Ann Thorac Surg. 2007;83:S877–S881
  14. Jacobs MJ, de Mol BA, Elenbaas T, Mess WH, Kalkman CJ. Spinal cord blood supply in patients with thoracoabdominal aortic aneurysm. J Vasc Surg. 2002;35:30–37
  15. Griepp RB, Ergin MA, Galla JD, Lansman S, Khan N, Quintana C, et al. Looking for the artery of Adamkiewicz: a quest to minimize paraplegia after operations for aneurysms of the descending thoracic and thoracoabdominal aorta. J Thorac Cardiovasc Surg. 1996;112:1202–1213
  16. Cheung AT, Pochettino A, Guvakov DV, Weiss SJ, Shanmugan S, Bavaria JE. Safety of lumbar drains in thoracic aortic operations performed with extracorporeal circulation. Ann Thorac Surg. 2003;76:1190–1197
  17. Dardik A, Perler BA, Roseborough GS, Williams GM. Subdural hematoma after thoracoabdominal aortic aneurysm repair: an underreported complication of spinal fluid drainage?. J Vasc Surg. 2002;36:47–50
  18. Weaver KD, Wiseman DB, Farber M, Ewend MG, Marston W, Keagy BA. Complications of lumbar drainage after thoracoabdominal aortic aneurysm repair. J Vasc Surg. 2001;34:623–627

 Competition of interest: none.

PII: S0741-5214(08)00886-0

doi: 10.1016/j.jvs.2008.05.073

Journal of Vascular Surgery
Volume 48, Issue 4 , Pages 836-840 , October 2008

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