Sorelius, Karl, Mani, Kevin, Bjorck, Martin, Sedivy, Petr, Wahlgren, Carl-Magnus, Taylor, Peter, Clough, Rachel E., Lyons, Oliver ORCID: 0000-0002-7731-7343, Thompson, Matt, Brownrigg, Jack, Ivancev, Krassi, Davis, Meryl, Jenkins, Michael P., Jaffer, Usman, Bown, Matt, Rancic, Zoran, Mayer, Dieter, Brunkwall, Jan, Gawenda, Michael, Koelbel, Tilo, Jean-Baptiste, Elixene ORCID: 0000-0002-2571-7302, Moll, Frans, Berger, Paul, Liapis, Christos D., Moulakakis, Konstantinos G., Langenskiold, Marcus, Roos, Hakan, Larzon, Thomas, Pirouzram, Artai and Wanhainen, Anders (2014). Endovascular Treatment of Mycotic Aortic Aneurysms A European Multicenter Study. Circulation, 130 (24). S. 2136 - 2144. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1524-4539

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Abstract

Background-Mycotic aortic aneurysm (MAA) is a rare and life-threatening disease. The aim of this European multicenter collaboration was to study the durability of endovascular aortic repair (EVAR) of MAA, by assessing late infection-related complications and long-term survival. Methods and Results-All EVAR treated MAAs, between 1999 and 2013 at 16 European centers, were retrospectively reviewed. One hundred twenty-three patients with 130 MAAs were identified. Mean age was 69 years (range 39-86), 87 (71%) were men, 58 (47%) had immunodeficiency, and 47 (38%) presented with rupture. Anatomic locations were ascending/arch (n=4), descending (n=34), paravisceral (n=15), infrarenal aorta (n=63), and multiple (n=7). Treatments were thoracic EVAR (n=43), fenestrated/branched EVAR (n=9), and infrarenal EVAR (n=71). Antibiotic was administered for mean 30 weeks. Mean follow-up was 35 months (range 1 week to 149 months). Six patients (5%) were converted to open repair during follow-up. Survival was 91% (95% confidence interval, 86% to 96%), 75% (67% to 83%), 55% (44% to 66%), and 41% (28% to 54%) after 1, 12, 60, and 120 months, respectively. Infection-related death occurred in 23 patients (19%), 9 after discontinuation of antibiotic treatment. A Cox regression analysis demonstrated non-Salmonella-positive culture as predictors for late infection-related death. Conclusions-Endovascular treatment of MAA is feasible and for most patients a durable treatment option. Late infections do occur, are often lethal, and warrant long-term antibiotic treatment and follow-up. Patients with non-Salmonellapositive blood cultures were more likely to die from late infection.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Sorelius, KarlUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mani, KevinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bjorck, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sedivy, PetrUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wahlgren, Carl-MagnusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Taylor, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Clough, Rachel E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lyons, OliverUNSPECIFIEDorcid.org/0000-0002-7731-7343UNSPECIFIED
Thompson, MattUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brownrigg, JackUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ivancev, KrassiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Davis, MerylUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jenkins, Michael P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jaffer, UsmanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bown, MattUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rancic, ZoranUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mayer, DieterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brunkwall, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gawenda, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koelbel, TiloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jean-Baptiste, ElixeneUNSPECIFIEDorcid.org/0000-0002-2571-7302UNSPECIFIED
Moll, FransUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Berger, PaulUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liapis, Christos D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moulakakis, Konstantinos G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Langenskiold, MarcusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Roos, HakanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Larzon, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pirouzram, ArtaiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wanhainen, AndersUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-420360
DOI: 10.1161/CIRCULATIONAHA.114.009481
Journal or Publication Title: Circulation
Volume: 130
Number: 24
Page Range: S. 2136 - 2144
Date: 2014
Publisher: LIPPINCOTT WILLIAMS & WILKINS
Place of Publication: PHILADELPHIA
ISSN: 1524-4539
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
TERM-FOLLOW-UP; ABDOMINAL-AORTA; ILIAC ARTERIES; INFECTED ANEURYSM; THORACIC AORTA; REPAIR; EXPERIENCE; POPULATION; SALMONELLA; SURVIVALMultiple languages
Cardiac & Cardiovascular Systems; Peripheral Vascular DiseaseMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/42036

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