131 151

Cited 6 times in

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

Authors
 Seungjun Song  ;  Suk-Won Song  ;  Tae Hoon Kim  ;  Kwang-Hun Lee  ;  Kyung-Jong Yoo 
Citation
 JOURNAL OF THORACIC DISEASE, Vol.9(8) : 2404-2412, 2017 
Journal Title
 JOURNAL OF THORACIC DISEASE 
ISSN
 2072-1439 
Issue Date
2017
Keywords
Thoracic endovascular aortic repair (TEVAR) ; cerebrospinal fluid drainage (CSFD) ; spinal cord injury (SCI)
Abstract
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.
Files in This Item:
T201703104.pdf Download
DOI
10.21037/jtd.2017.07.03
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Song, Suk Won(송석원) ORCID logo https://orcid.org/0000-0002-9850-9707
Yoo, Kyung Jong(유경종) ORCID logo https://orcid.org/0000-0002-9858-140X
Lee, Kwang Hun(이광훈)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160716
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links