PROTOCOL FOR THE USE OF CEREBROSPINAL FLUID DRAINAGE IN THORACOABDOMINAL ANEURYSM SURGERY
DOI:
https://doi.org/10.48750/acv.29Keywords:
Thoracoabdominal aortic aneurysm, cerebrospinal fluid drainage, spinal cord protectionAbstract
Paraplegia is a devastating and well recognized complication of thoracoabdominal aortic aneurysm repair surgery, with cerebrospinal fluid drainage systems emerging as an important measure to improve neurological outcome. The protocol elaborated by the authors consists of several documents that guide the placement of the drainage system, its maintenance, the handling and the hemodynamic goals for the intraoperative and postoperative period, the interventions to be taken in case of neurological deficit and the withdrawal of the drainage catheter with safety. It is imperative to familiarize the different members of the medical and nursing teams with the usage rules of this system. The main objective is to optimize the approach of these patients in order to improve their neurological outcome and to minimize the risk of complications.
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References
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11. Acher C, Acher CW, Marks E, Wynn M. Intraoperative neuroprotective interventions prevent spinal cord ischemia and injury in thoracic endovascular aortic repair. J. Vasc Surg. 2016 Jun; 63(6):1458-65
12. Bobadilla JL, Wynn M, Tefera G, Acher CW. Low incidence of paraplegia after thoracic endovascular aneurysm repair with proactive spinal cord protective protocols. J Vasc Surg. 2013 Jun;57(6):1537-42. doi: 10.1016/j.jvs.2012.12.032. Epub 2013 Mar 13.
13. Fonseca C, Alves J, Araújo F. Manuseio Peri-operatório dos doentes medicados com anticoagulantes e antiagregantes plaquetarios: resultado da 3ª reunião de consenso da Sociedade Portuguesa de Anestesiologia. Ver Soc Port Anestesiol 2014, Vol. 23 - nº3,76-93
14. McGarvey ML, Mullen MT, Woo EY, Bavaria JE, Augoustides YG, Messé SR, Cheung AT. The treatment of spinal cord ischemia following thoracic endovascular aortic repair. Neurocrit Care. 2007;6(1):35-9.
15. Estrera A, Sheinbaum Roy, Miller C, Aizzadeh A, Walkes JC, Lee TY, Kaiser L, Safi H. Cerebrospinal Fluid Drainage During Thoracic Aortic Repair: Safety and Current Management. Ann Thorac Surg 2009;88:9-15.
16. Youngblood SC, Tolpin DA, LeMaire SA, Coselli JS, Lee VV, Cooper JR. Complications of cerebrospinal fluid drainage after thoracic aortic surgery: a review of 504 patients over 5 years. J Thorac Cardiovasc Surg 2013;146:166-71.
17. Riambau V, Capoccia L, Mestres G, Matute P. Spinal cord protection and related complications in endovascular management of B dissection: LSA revascularization and CSF drainage. Ann Cardiothorac Surg. 2014 May;3(3):336-8
2. Wong CS, Healy D, Canning C, Coffey JC, Boyle JR, Walsh SR. A systematic review of spinal cord injury and cerebrospinal fluid drainage after thoracic aortic endografting. J VascSurg. 2012 Nov;56(5):1438-47
3. Augoustides JG, Stone ME, Drenger B. Novel approaches to spinal cord protection during thoracoabdominal aortic interventions. Curr Opin Anaesthesiol. 2014 Feb;27(1):98-105
4. Becker DA1, McGarvey ML, Rojvirat C, Bavaria JE, Messé SR. Predictors of outcome in patients with spinal cord ischemia after open aortic repair. Neurocrit Care. 2013 Feb;18(1):70-4. doi: 10.1007/s12028-012-9807-9.
5. Khan SN, Stansby G. Cerebrospinal fluid drainage for thoracic and thoracoabdominal aortic aneurysm surgery. Cochrane Database Syst Rev. 2012 Oct 17;10:CD003635
6. Fedorow CA, Moon MC, Mutch WA, Grocott HP. Lumbar Cerebrospinal Fluid Drainage for Thoracoabdominal Aortic Surgery: Rationale and Practical Considerations for Management. Anesth Analg. 2010 Jul;111(1):46-58
7. Cinà CS, Abouzahr L, Arena GO, Laganà A, Devereaux PJ, Farrokhyar F. Cerebrospinal fluid drainage to prevent paraplegia during thoracic and thoracoabdominal aortic aneurysm surgery: a systematic review and meta-analysis. J Vasc Surg. 2004 Jul;40(1):36-44.
8. Field M, Doolan J, Safar M, Kuduvalli M, Oo A, Mills K, Kendall J, Desmond M. The safe use of spinal drains in thoracic aortic surgery. Interact Cardiovasc Thorac Surg 2011;13(6):557-65
9. Cole SP. Intensive Care Management of Thoracic Aortic Surgical Patients, Including Thoracic and Infradiaphragmatic Endovascular Repair (EVAR/TEVAR). Semin Cardiothorac Vasc Anesth, 2015, Vol. 19(4) 331–341
10. Etz CD, Weigang E, Hartert M, Lonn L, Mestres CA, Di Bartolomeo R et al. Contemporary spinal cord protection during thoracic and thoracoabdominal aortic surgery and endovascular aortic repair: a position paper of the vascular domain of the European Association for Cardio-Thoracic Surgery. Eur J Cardiothorac Surg 2015;47:943–57.
11. Acher C, Acher CW, Marks E, Wynn M. Intraoperative neuroprotective interventions prevent spinal cord ischemia and injury in thoracic endovascular aortic repair. J. Vasc Surg. 2016 Jun; 63(6):1458-65
12. Bobadilla JL, Wynn M, Tefera G, Acher CW. Low incidence of paraplegia after thoracic endovascular aneurysm repair with proactive spinal cord protective protocols. J Vasc Surg. 2013 Jun;57(6):1537-42. doi: 10.1016/j.jvs.2012.12.032. Epub 2013 Mar 13.
13. Fonseca C, Alves J, Araújo F. Manuseio Peri-operatório dos doentes medicados com anticoagulantes e antiagregantes plaquetarios: resultado da 3ª reunião de consenso da Sociedade Portuguesa de Anestesiologia. Ver Soc Port Anestesiol 2014, Vol. 23 - nº3,76-93
14. McGarvey ML, Mullen MT, Woo EY, Bavaria JE, Augoustides YG, Messé SR, Cheung AT. The treatment of spinal cord ischemia following thoracic endovascular aortic repair. Neurocrit Care. 2007;6(1):35-9.
15. Estrera A, Sheinbaum Roy, Miller C, Aizzadeh A, Walkes JC, Lee TY, Kaiser L, Safi H. Cerebrospinal Fluid Drainage During Thoracic Aortic Repair: Safety and Current Management. Ann Thorac Surg 2009;88:9-15.
16. Youngblood SC, Tolpin DA, LeMaire SA, Coselli JS, Lee VV, Cooper JR. Complications of cerebrospinal fluid drainage after thoracic aortic surgery: a review of 504 patients over 5 years. J Thorac Cardiovasc Surg 2013;146:166-71.
17. Riambau V, Capoccia L, Mestres G, Matute P. Spinal cord protection and related complications in endovascular management of B dissection: LSA revascularization and CSF drainage. Ann Cardiothorac Surg. 2014 May;3(3):336-8
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Published
2018-12-02
How to Cite
1.
Ferreira M, Antunes P, Rodrigues M, Alves Ângela, Conde P. PROTOCOL FOR THE USE OF CEREBROSPINAL FLUID DRAINAGE IN THORACOABDOMINAL ANEURYSM SURGERY. Angiol Cir Vasc [Internet]. 2018 Dec. 2 [cited 2024 Nov. 24];14(1):35-4. Available from: https://acvjournal.com/index.php/acv/article/view/29
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Review Article
