{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:10:00Z","timestamp":1788876600281,"version":"build-2803163510"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Cerebrospinal fluid drainage (CSFD) is commonly used to manage spinal cord injury (SCI) after aortic surgery. However, there is still limited evidence regarding its effectiveness in patients with type A aortic dissection undergoing total arch replacement plus frozen elephant trunk procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 1931 patients were retrospectively enrolled between 2010 and 2023. Patients with high\u2010risk postoperative SCI (N=445) were divided into 2 groups: with or without prophylactic CSFD to evaluate the protective effect of prophylactic CSFD. Patients with postoperative SCI (N=119) were divided into 3 groups, without CSFD, therapeutic CSFD, and prophylactic CSFD, and analyzed to compare the treatment effect of different CSFD strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Prophylactic CSFD significantly reduced the incidence of postoperative SCI in high\u2010risk patients (26.9% versus 17.7%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.029), further supported by matching weights analysis of propensity score and conditional logistic regression. Analyses of the SCI population revealed less severe SCI symptoms in patients with prophylactic CSFD, as assessed by the American Spinal Injury Association Impairment Scale (adjusted\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.05). Multivariable ordinal logistic regression showed that compared with those without CSFD, prophylactic CSFD (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.003) but not therapeutic CSFD (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.981) was beneficial to the in\u2010hospital recovery of postoperative SCI. Long\u2010term SCI outcomes did not differ among groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">A prominent protective effect on SCI occurrence and recovery after the total arch replacement plus the frozen elephant trunk procedure was observed with prophylactic CSFD use in patients with type A aortic dissection. However, the effectiveness of therapeutic CSFD fell short of significance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.039427","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T06:10:37Z","timestamp":1740550237000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Protective Effect on Spinal Cord Injury of Prophylactic Cerebrospinal Fluid Drainage in Extensive Aortic Arch Repair for Type A Aortic Dissection: A Retrospective Cohort Study"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3297-5879","authenticated-orcid":false,"given":"Chenyu","family":"Zhou","sequence":"first","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, 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