title: Complications to cerebrospinal fluid drainage and predictors of spinal cord ischemia in patients with aortic disease undergoing advanced endovascular therapy.
abstract: 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.
authors.affiliation: Vascular Center, Skåne University Hospital, Malmö, Sweden.
authors.forename: Irma
authors.initials: I
authors.lastname: Mehmedagic
authors.forename: Timothy
authors.initials: T
authors.lastname: Resch
authors.forename: Stefan
authors.initials: S
authors.lastname: Acosta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001014:Aortic Aneurysm / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001019:Aortic Rupture / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004322:Drainage / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D020760:Spinal Cord Ischemia / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: cerebrospinal fluid drainage; endovascular therapy; spinal cord ischemia; thoracoabdominal aortic aneurysm