Yuki Ikeno, Gregory A Estrera, Nicholas Ray, Michael J Troncone, Harleen Sandhu, Charles C Miller, Shao Feng Zhou, Akiko Tanaka, Hazim J Safi, Anthony L Estrera
{"title":"开降胸胸腹主动脉瘤修复术后脑脊液引流的并发症。","authors":"Yuki Ikeno, Gregory A Estrera, Nicholas Ray, Michael J Troncone, Harleen Sandhu, Charles C Miller, Shao Feng Zhou, Akiko Tanaka, Hazim J Safi, Anthony L Estrera","doi":"10.1016/j.jvs.2025.07.031","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to review a 10-year experience, identify cerebrospinal fluid drainage (CSFD)-related complications, and evaluate its utility in spinal cord protection.</p><p><strong>Methods: </strong>This retrospective study reviewed all open descending thoracic aneurysm and thoracoabdominal aortic aneurysm (DTA/TAAA) repairs performed at our institution between January 2013 and September 2024. The analysis focused on patients who underwent CSFD for preoperative spinal cord protection.</p><p><strong>Results: </strong>Of the 428 patients who underwent open DTA/TAAA repair, 339 received CSFD and were included in the analysis. DTA was performed in 107 patients (31.7%), while TAAA was performed in 232 (68.4%). Emergency surgeries were required in 40 patients (11.8%). Operative mortality was 5.3% (18 patients). Early SCI was observed in 2.9% (10), while delayed SCI occurred in 10.6% (36). The mean duration of CSFD drainage was 3.4 ± 1.9 days. CSFD-related complications were observed in 85 patients (25.1%), with major complications, including intracranial hemorrhage in 7 (2.1%), one of which required surgical intervention (0.3%). Meningitis was noted in 2 patients (0.6%). Minor complications included spinal headache in 55 (16.2%) and CSFD leakage in 27 (8.0%). Bloody drainage occurred in 29 (8.6%) and CSFD catheter malfunction in 9 (2.7%), rendering CSFD unusable in 18 patients (5.3%).</p><p><strong>Conclusion: </strong>Open DTA/TAAA repairs with CSFD showed acceptable outcomes. Although minor complications were relatively frequent, major complications were rare at this experienced center.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Complications of Cerebrospinal Fluid Drainage after Open Descending Thoracic and Thoracoabdominal Aortic Aneurysm Repair.\",\"authors\":\"Yuki Ikeno, Gregory A Estrera, Nicholas Ray, Michael J Troncone, Harleen Sandhu, Charles C Miller, Shao Feng Zhou, Akiko Tanaka, Hazim J Safi, Anthony L Estrera\",\"doi\":\"10.1016/j.jvs.2025.07.031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>This study aims to review a 10-year experience, identify cerebrospinal fluid drainage (CSFD)-related complications, and evaluate its utility in spinal cord protection.</p><p><strong>Methods: </strong>This retrospective study reviewed all open descending thoracic aneurysm and thoracoabdominal aortic aneurysm (DTA/TAAA) repairs performed at our institution between January 2013 and September 2024. The analysis focused on patients who underwent CSFD for preoperative spinal cord protection.</p><p><strong>Results: </strong>Of the 428 patients who underwent open DTA/TAAA repair, 339 received CSFD and were included in the analysis. DTA was performed in 107 patients (31.7%), while TAAA was performed in 232 (68.4%). Emergency surgeries were required in 40 patients (11.8%). Operative mortality was 5.3% (18 patients). Early SCI was observed in 2.9% (10), while delayed SCI occurred in 10.6% (36). The mean duration of CSFD drainage was 3.4 ± 1.9 days. CSFD-related complications were observed in 85 patients (25.1%), with major complications, including intracranial hemorrhage in 7 (2.1%), one of which required surgical intervention (0.3%). Meningitis was noted in 2 patients (0.6%). Minor complications included spinal headache in 55 (16.2%) and CSFD leakage in 27 (8.0%). Bloody drainage occurred in 29 (8.6%) and CSFD catheter malfunction in 9 (2.7%), rendering CSFD unusable in 18 patients (5.3%).</p><p><strong>Conclusion: </strong>Open DTA/TAAA repairs with CSFD showed acceptable outcomes. 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Complications of Cerebrospinal Fluid Drainage after Open Descending Thoracic and Thoracoabdominal Aortic Aneurysm Repair.
Objectives: This study aims to review a 10-year experience, identify cerebrospinal fluid drainage (CSFD)-related complications, and evaluate its utility in spinal cord protection.
Methods: This retrospective study reviewed all open descending thoracic aneurysm and thoracoabdominal aortic aneurysm (DTA/TAAA) repairs performed at our institution between January 2013 and September 2024. The analysis focused on patients who underwent CSFD for preoperative spinal cord protection.
Results: Of the 428 patients who underwent open DTA/TAAA repair, 339 received CSFD and were included in the analysis. DTA was performed in 107 patients (31.7%), while TAAA was performed in 232 (68.4%). Emergency surgeries were required in 40 patients (11.8%). Operative mortality was 5.3% (18 patients). Early SCI was observed in 2.9% (10), while delayed SCI occurred in 10.6% (36). The mean duration of CSFD drainage was 3.4 ± 1.9 days. CSFD-related complications were observed in 85 patients (25.1%), with major complications, including intracranial hemorrhage in 7 (2.1%), one of which required surgical intervention (0.3%). Meningitis was noted in 2 patients (0.6%). Minor complications included spinal headache in 55 (16.2%) and CSFD leakage in 27 (8.0%). Bloody drainage occurred in 29 (8.6%) and CSFD catheter malfunction in 9 (2.7%), rendering CSFD unusable in 18 patients (5.3%).
Conclusion: Open DTA/TAAA repairs with CSFD showed acceptable outcomes. Although minor complications were relatively frequent, major complications were rare at this experienced center.
期刊介绍：
Journal of Vascular Surgery ® aims to be the premier international journal of medical, endovascular and surgical care of vascular diseases. It is dedicated to the science and art of vascular surgery and aims to improve the management of patients with vascular diseases by publishing relevant papers that report important medical advances, test new hypotheses, and address current controversies. To acheive this goal, the Journal will publish original clinical and laboratory studies, and reports and papers that comment on the social, economic, ethical, legal, and political factors, which relate to these aims. As the official publication of The Society for Vascular Surgery, the Journal will publish, after peer review, selected papers presented at the annual meeting of this organization and affiliated vascular societies, as well as original articles from members and non-members.
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