Abstract | Background: Methods: A literature search of five databases was performed and all studies published before September 2022 that reported SCI rates in TEVAR patients undergoing prophylactic CSFD were included. A random effects meta-analysis of means or proportions was performed for single-arm data. Odds ratios ( ORs) with 95% confidence intervals (CIs) were reported for comparisons between groups. Results: A total of 4,793 patients undergoing TEVAR from 40 studies were included. The mean age was 68.8 years and 70.9% of patients were male. The overall SCI rate was 3.5%, with a 1.3% rate of immediate SCI and a 1.9% rate of delayed SCI. There were no significant differences in SCI rates between prophylactic CSFD patients and non-drained patients. Routine CSFD did not have a significant impact on SCI rates compared to non-drained patients. There was an increased rate of transient SCI with selective CSFD compared to non-drained patients (OR 2.08; 95% CI: 1.06-4.08; P=0.03). The most common drain-related complication was spinal headache (4.3%). The major complication rate was 1.6%, of which epidural or spinal hematoma (0.9%) was the most common, followed by intracranial or subdural hemorrhage (0.8%) and paraparesis or paraplegia (0.8%). Conclusions: This study found no significant difference in SCI rates between prophylactic CSFD patients and their non-drained counterparts. CSFD is associated with a small but non-negligible risk of serious complications. Multi-center randomized controlled trials (RCTs) are warranted to help stratify the risk of both SCI and CSFD-related complications in patients undergoing endovascular aortic procedures.
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Authors | Cheng-Hao Jacky Chen, Henry Jiang, Vinh Dat David Nguyen |
Journal | Annals of cardiothoracic surgery
(Ann Cardiothorac Surg)
Vol. 12
Issue 5
Pg. 392-408
(Sep 28 2023)
ISSN: 2225-319X [Print] China |
PMID | 37817857
(Publication Type: Journal Article)
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Copyright | 2023 Annals of Cardiothoracic Surgery. All rights reserved. |