{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:18:50Z","timestamp":1792793930746,"version":"4.5.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Heisenberg-Professorship for Aortic Surgery of the German Research Foundation","id":[{"id":"https:\/\/ror.org\/018mejw64","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100004807","name":"DFG","doi-asserted-by":"publisher","award":["278040814"],"award-info":[{"award-number":["278040814"]}],"id":[{"id":"10.13039\/100004807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p\/>\n                  <jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>Cerebrospinal fluid (CSF) drainage is routinely utilized to mitigate perioperative and postoperative spinal cord ischaemia in open and endovascular thoraco-abdominal aortic aneurysm repair to prevent permanent paraplegia. Clinical decision-making in the vulnerable perioperative period, however, is still based on limited clinical and experimental data. Our aim was to investigate the isolated effect of CSF pressure elevation on spinal cord perfusion in an established large animal model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Ten juvenile pigs with normal (native) arterial inflow (patent segmental arteries and collaterals) underwent iatrogenic CSF pressure elevation (\u00d72, \u00d73, \u00d74 from their individual baseline pressure). Each pressure level was maintained for 30\u2009min to mimic clinical response time. After the quadrupling of CSF pressure, the dural sac was slowly depressurized against gravity allowing CSF pressure to passively return to baseline values. Measurements were taken 30 and 60\u2009min after normalization, and microspheres for regional blood flow analysis were injected at each time point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Spinal cord perfusion decreased significantly at all mid-thoracic to lumbar cord segments at the doubling of CSF pressure and declined to values &amp;lt;53% compared to baseline when pressure was quadrupled. Normalizing CSF pressure led to an intense hyperperfusion of up to 186% at the cervical level and 151% within the lumbar region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>CSF pressure elevation results in a relevant impairment of spinal cord blood supply. Close perioperative and postoperative monitoring of CSF pressure is crucial for maintaining sufficient spinal cord perfusion. Radical and rapid withdrawal of CSF is followed by significant hyperperfusion in all spinal cord segments and may lead to \u2018drainage-related\u2019 iatrogenic reperfusion injury\u2014aggravating the risk of delayed spinal cord injury\u2014and should therefore be avoided.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejcts\/ezaa038","type":"journal-article","created":{"date-parts":[[2020,1,22]],"date-time":"2020-01-22T07:10:10Z","timestamp":1579677010000},"page":"286-293","source":"Crossref","is-referenced-by-count":9,"title":["Detrimental effects of cerebrospinal fluid pressure elevation on spinal cord perfusion: first-time direct detection in a large animal model"],"prefix":"10.1093","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1742-5841","authenticated-orcid":false,"given":"Josephina","family":"Haunschild","sequence":"first","affiliation":[{"name":"University Department for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin","family":"von Aspern","sequence":"additional","affiliation":[{"name":"University Department for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zara","family":"Khachatryan","sequence":"additional","affiliation":[{"name":"Heisenberg Working Group for Aortic Surgery, Saxonian Incubator for Clinical Translation, University of Leipzig, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Bianchi","sequence":"additional","affiliation":[{"name":"University Department for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2383-9672","authenticated-orcid":false,"given":"Till","family":"Friedheim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Wipper","sequence":"additional","affiliation":[{"name":"Department of Vascular Medicine, German Aortic Center Hamburg, University Heart Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5791-3212","authenticated-orcid":false,"given":"Constantin J","family":"Trepte","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5218-3126","authenticated-orcid":false,"given":"Susann","family":"Ossmann","sequence":"additional","affiliation":[{"name":"University Department for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Borger","sequence":"additional","affiliation":[{"name":"University Department for Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8224-2390","authenticated-orcid":false,"given":"Christian D","family":"Etz","sequence":"additional","affiliation":[{"name":"University Department for Cardiac Surgery, Leipzig Heart Center, Leipzig, 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