Current Perioperative Management of CSF Drains for Repair of TAAA and DTAA Surgery

As both open and endovascular surgery for descending thoracic aortic aneurysms (DTAA) and thoracoabdominal aortic aneurysm (TAAA) have increased, there has also been an increase in the request for cerebrospinal fluid drainage (CSFd). Routinely performed in elective TAAA, a lower lumbar approach drain catheter is placed preoperatively and CSF is intermittently drained with the goal of maintaining intracranial pressure (ICP) less than central venous pressure (CVP) or less than 10 mmHg. This adjunct technique is continued into the postoperative period until the patient has maintained intact neurologic function. Most CSFd placement can be elective.