• Anesthesiology · Dec 2024

    Review

    Role for Lumbar Cerebrospinal Fluid Drainage in High-risk Thoracic Endovascular Aortic Repair: A Narrative Review.

    • Thomas Shelton, Bradley Gigax, Ahmed H Aly, Katherine Choi, Esmerina Tili, Kristine Orion, Bijan Modarai, Adam Beck, Hilary P Grocott, and Hamdy Awad.
    • The Ohio State University College of Medicine, Columbus, Ohio.
    • Anesthesiology. 2024 Dec 1; 141 (6): 117511901175-1190.

    AbstractLumbar cerebrospinal fluid (CSF) drainage is one of the few preventative and therapeutic practices that may reduce spinal cord ischemia in high-risk thoracic endovascular aortic aneurysm repair (TEVAR). Although this is part of clinical guidelines in open thoracoabdominal aortic repair, there are no randomized controlled trials that provide convincing evidence on the protection conferred by CSF drainage in high-risk TEVAR patients. This gap in knowledge obfuscates clinical decision making given the risk of significant complications of CSF drain insertion and management. The current literature is inconclusive and provides conflicting results regarding the efficacy of, and complications from, CSF drainage in TEVAR. Filling the knowledge gap resulting from the limited current state of the literature warrants additional high-quality randomized controlled clinical trials that balance CSF drainage efficacy with potential complications in high-risk TEVAR patients.Copyright © 2024 American Society of Anesthesiologists. All Rights Reserved.

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