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We retrospectively reviewed the medical records of 11 patients who were referred by anesthesiologists to an interventional neuroradiologist for fluoroscopy-guided lumbar spinal drain insertion for thoracic aortic aneurysm repair between January 2010 and June 2015. Successful drain insertion was achieved in all patients. Three (27.3%) patients developed drain-related complications. Fluoroscopy-guided spinal drain insertion is an alternative to the conventional, nonimage-guided, blind technique used by anesthesiologists when they expect to encounter difficulty with insertion or in cases of failed insertion.