Safety and efficacy of fluoroscopically guided cerebrospinal fluid drainage for thoracoabdominal aortic aneurysm repair
Bibliographic record
Abstract
To review the safety and efficacy of perioperative cerebrospinal fluid (CSF) drainage catheter placement using fluoroscopic guidance in patients undergoing thoracoabdominal aortic aneurysm (TAAA) repair. Research Ethics Board approval was obtained for this retrospective study. The medical records of patients who underwent fluoroscopically guided lumbar CSF drainage between September 2008 and April 2021 were reviewed. Major complications were defined as CSF leak requiring a blood patch, intracranial hemorrhage, meningitis, symptomatic spinal hematoma, bloody tap causing a delay in surgery, catheter fracture or occlusion, and death. Minor complications included CSF leak not requiring intervention, asymptomatic spinal hematoma, and bloody tap without surgical delay. Eighty-four drainage catheters were attempted in 75 consecutive patients (age, 70.8 ± 8.9 years; 67.9% male) for 15 thoracic endovascular aortic repairs (TEVARs), 59 complex (fenestrated/branched) endovascular aortic repairs (EVARs), and 10 open repairs for 76 aneurysms (90.5%), 1 acute dissection (1.2%), and 7 chronic dissections with aneurysms (8.3%). The technical success rate was 97.6% (82/84). Bloody tap accounted for both technical failures. Most catheters were placed prophylactically (89.3%). There were 4 major complications (2 bloody taps causing a delay in surgery, 1 catheter occlusion, and 1 symptomatic spinal hematoma) and 2 minor complications (CSF leak with no intervention and asymptomatic spinal hematoma). The use of fluoroscopic guidance for CSF drainage catheter placement in patients undergoing open or endovascular TAAA repair is associated with a low complication rate and high technical success rate.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.032 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".