Lumbar 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.

中文翻译：

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腰椎脑脊液引流在高危胸腔内主动脉修复中的作用：叙述性回顾。


腰椎脑脊液 （CSF） 引流是高危胸主动脉瘤修复术 （TEVAR） 中为数不多的可以减少脊髓缺血的预防和治疗措施之一。尽管这是开腹胸主动脉修复术临床指南的一部分，但没有随机对照试验提供令人信服的证据来证明脑脊液引流对高危 TEVAR 患者的保护作用。考虑到 CSF 引流管插入和管理的严重并发症风险，这种知识差距使临床决策变得模糊。目前的文献尚无定论，并且关于 TEVAR 中 CSF 引流的疗效和并发症提供了相互矛盾的结果。填补因文献当前状态有限而造成的知识空白需要额外的高质量随机对照临床试验，以平衡 CSF 引流效果与高危 TEVAR 患者的潜在并发症。