Paraplegia, one of the most significant postoperative complications for patients undergoing thoracic and thoracoabdominal aortic aneurysm surgery, results from too little perfusion to the spinal nerves.1,2 Time with an aortic cross-clamp in place, hypothermia, and reperfusion injury are a few of the contributing factors. Wan et al3 reported that the risk of paraplegia with reconstructive surgery ranges between 5% and 40%, and potential improvements are achieved with distal aortic perfusion techniques and cerebrospinal fluid (CSF) drainage. Safi et al4 proposed a 16% to 31% risk of paraplegia with high-risk thoracoabdominal aortic aneurysm repair. This risk can increase to 50% with a cross-clamp in place longer than 45 minutes.4 The risk with thoracic endovascular repair is much lower at 1.5%, although that risk increases to 2.88% when protocols are not used, and to 5.6% when protocols are applied inconsistently.5,6
Lumbar drainage catheters...