Nationwide Study on Treatment of Mycotic Thoracic Aortic Aneurysms

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Nationwide Study on Treatment of Mycotic Thoracic Aortic Aneurysms. / Sörelius, K.; Wanhainen, A.; Wahlgren, C. M.; Langenskiöld, M.; Roos, H.; Resch, T.; Vaccarino, R.; Arvidsson, B.; Gillgren, P.; Bilos, L.; Pirouzram, A.; Holsti, M.; Mani, K.

In: European Journal of Vascular and Endovascular Surgery, Vol. 57, No. 2, 2019, p. 239-246.

Research output: Contribution to journalArticle

Harvard

Sörelius, K, Wanhainen, A, Wahlgren, CM, Langenskiöld, M, Roos, H, Resch, T, Vaccarino, R, Arvidsson, B, Gillgren, P, Bilos, L, Pirouzram, A, Holsti, M & Mani, K 2019, 'Nationwide Study on Treatment of Mycotic Thoracic Aortic Aneurysms', European Journal of Vascular and Endovascular Surgery, vol. 57, no. 2, pp. 239-246. https://doi.org/10.1016/j.ejvs.2018.08.052

APA

Sörelius, K., Wanhainen, A., Wahlgren, C. M., Langenskiöld, M., Roos, H., Resch, T., ... Mani, K. (2019). Nationwide Study on Treatment of Mycotic Thoracic Aortic Aneurysms. European Journal of Vascular and Endovascular Surgery, 57(2), 239-246. https://doi.org/10.1016/j.ejvs.2018.08.052

CBE

Sörelius K, Wanhainen A, Wahlgren CM, Langenskiöld M, Roos H, Resch T, Vaccarino R, Arvidsson B, Gillgren P, Bilos L, Pirouzram A, Holsti M, Mani K. 2019. Nationwide Study on Treatment of Mycotic Thoracic Aortic Aneurysms. European Journal of Vascular and Endovascular Surgery. 57(2):239-246. https://doi.org/10.1016/j.ejvs.2018.08.052

MLA

Vancouver

Author

Sörelius, K. ; Wanhainen, A. ; Wahlgren, C. M. ; Langenskiöld, M. ; Roos, H. ; Resch, T. ; Vaccarino, R. ; Arvidsson, B. ; Gillgren, P. ; Bilos, L. ; Pirouzram, A. ; Holsti, M. ; Mani, K. / Nationwide Study on Treatment of Mycotic Thoracic Aortic Aneurysms. In: European Journal of Vascular and Endovascular Surgery. 2019 ; Vol. 57, No. 2. pp. 239-246.

RIS

TY - JOUR

T1 - Nationwide Study on Treatment of Mycotic Thoracic Aortic Aneurysms

AU - Sörelius, K.

AU - Wanhainen, A.

AU - Wahlgren, C. M.

AU - Langenskiöld, M.

AU - Roos, H.

AU - Resch, T.

AU - Vaccarino, R.

AU - Arvidsson, B.

AU - Gillgren, P.

AU - Bilos, L.

AU - Pirouzram, A.

AU - Holsti, M.

AU - Mani, K.

PY - 2019

Y1 - 2019

N2 - Objective/background: Mycotic aortic aneurysms are rare, life threatening, and complex. This nationwide study aimed to assess outcome after repair of mycotic thoracic aortic aneurysms (MTAAs). Methods: Patients treated in Sweden for MTAAs between 2000 and 2016 were identified in the Swedish vascular registry (2010–16) and local patient registries (2000–09). Primary outcome was survival, and secondary outcomes included surgical strategy, rate of infection related complications (IRC), and re-operations. Results: Fifty-two patients (median age 71 ± 8.1 years; 28 [54%] men, 13 [25%] ruptured) were identified (3.6% of all thoracic aortic aneurysm repairs in Sweden). Aneurysm location was aortic arch (n = 6; 11%), descending aorta (n = 42; 81%), and multiple locations (n = 4; 8%). Twenty-nine (56%) patients had positive cultures; the most prevalent agent was Staphylococcus aureus (n = 16; 31%). Operative techniques included thoracic endovascular aortic repair (TEVAR; n = 35 [67%]), fenestrated/branched TEVAR (n = 8; 15%), hybrid repair (n = 7; 14%), and open patch repair (n = 2; 4%). Survival was 92% (95% confidence interval [CI] 88–96) at 30 days, 88% (95% CI 84–93) at three months, 78% (73–84) at one year, and 71% (64–77) at five years. The mean follow up among survivors (> 90 days) was 45 months (range 4–216 months). Antibiotics were administered for a median of 15 weeks (range 0–220 weeks). IRCs occurred in nine patients (17%): sepsis (n = 3), graft infection (n = 3), recurrent mycotic aneurysm (n = 1), aorto-oesophageal/bronchial fistula (n = 2). Six (67%) IRCs were fatal; 80% occurred within the first year. Re-operations were performed in nine patients (17%). Conclusions: TEVAR was often used as treatment for MTAAs, with acceptable short- and long-term survival when compared with open cohorts in the literature. IRCs are of concern and warrant follow up and long-term antibiotic treatment.

AB - Objective/background: Mycotic aortic aneurysms are rare, life threatening, and complex. This nationwide study aimed to assess outcome after repair of mycotic thoracic aortic aneurysms (MTAAs). Methods: Patients treated in Sweden for MTAAs between 2000 and 2016 were identified in the Swedish vascular registry (2010–16) and local patient registries (2000–09). Primary outcome was survival, and secondary outcomes included surgical strategy, rate of infection related complications (IRC), and re-operations. Results: Fifty-two patients (median age 71 ± 8.1 years; 28 [54%] men, 13 [25%] ruptured) were identified (3.6% of all thoracic aortic aneurysm repairs in Sweden). Aneurysm location was aortic arch (n = 6; 11%), descending aorta (n = 42; 81%), and multiple locations (n = 4; 8%). Twenty-nine (56%) patients had positive cultures; the most prevalent agent was Staphylococcus aureus (n = 16; 31%). Operative techniques included thoracic endovascular aortic repair (TEVAR; n = 35 [67%]), fenestrated/branched TEVAR (n = 8; 15%), hybrid repair (n = 7; 14%), and open patch repair (n = 2; 4%). Survival was 92% (95% confidence interval [CI] 88–96) at 30 days, 88% (95% CI 84–93) at three months, 78% (73–84) at one year, and 71% (64–77) at five years. The mean follow up among survivors (> 90 days) was 45 months (range 4–216 months). Antibiotics were administered for a median of 15 weeks (range 0–220 weeks). IRCs occurred in nine patients (17%): sepsis (n = 3), graft infection (n = 3), recurrent mycotic aneurysm (n = 1), aorto-oesophageal/bronchial fistula (n = 2). Six (67%) IRCs were fatal; 80% occurred within the first year. Re-operations were performed in nine patients (17%). Conclusions: TEVAR was often used as treatment for MTAAs, with acceptable short- and long-term survival when compared with open cohorts in the literature. IRCs are of concern and warrant follow up and long-term antibiotic treatment.

KW - Aneurysm

KW - Aorta

KW - Infected

KW - Mycotic

KW - Thoracic

KW - Treatment

U2 - 10.1016/j.ejvs.2018.08.052

DO - 10.1016/j.ejvs.2018.08.052

M3 - Article

VL - 57

SP - 239

EP - 246

JO - European journal of vascular and endovascular surgery

T2 - European journal of vascular and endovascular surgery

JF - European journal of vascular and endovascular surgery

SN - 1532-2165

IS - 2

ER -