Outcomes of Endovascular Treatment for Infectious Thoracic Aortic Diseases.

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of Vascular and Interventional Radiology Pub Date : 2024-10-19 DOI:10.1016/j.jvir.2024.10.012

Hiroaki Kato, Noriyuki Kato, Takafumi Ouchi, Takatoshi Higashigawa, Ken Nakajima, Shuji Chino, Hisato Ito, Toshiya Tokui, Toru Mizumoto, Kensuke Oue, Yasutaka Ichikawa, Hajime Sakuma

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引用次数: 0

Abstract

Purpose: To investigate the effectiveness and safety of thoracic endovascular aortic repair (TEVAR) for infectious aortic diseases.

Materials and methods: Patients who underwent TEVAR for infectious aortic diseases including infected thoracic aortic aneurysm, aortobronchial fistula (ABF), and aortoenteric fistula from December 2011 to October 2022 at 4 institutions were retrospectively studied. The primary outcome of the study was overall survival, whereas the secondary outcome was comprehensive adverse events. Comprehensive adverse events were defined as a combination of deaths, aortic events, and infectious adverse events.

Results: A total of 28 patients were included in the analysis, with 13 patients having infected thoracic aortic aneurysms, 12 ABFs, and 3 aortoenteric fistulae. Seven patients (25%) underwent additional procedures (abscess drainage, 6 cases; total esophagectomy, 1 case). The mean follow-up period was 30.0 months (SD ± 33.9). The 1-year and 5-year survival rates were 85.7% and 67.9%, respectively. The 1-year and 5-year aorta-related complication-free survival rates were 64.3% and 42.9%, respectively. On univariate analysis, the presence of an ABF was associated with a higher risk of comprehensive adverse events (odds ratio = 11; P = .04).

Conclusions: TEVAR might be a promising treatment for infectious thoracic aortic diseases. Among the infectious pathologies, ABF was considered ominous in terms of late outcomes.

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评估胸腔内血管治疗感染性主动脉疾病的效果。

目的：本研究旨在探讨胸腔内血管主动脉修补术治疗感染性主动脉疾病的疗效：回顾性研究2011年12月至2022年10月在四家机构接受胸腔内血管修复术治疗感染性主动脉疾病（包括霉菌性胸主动脉瘤、主动脉支气管瘘和主动脉肠瘘）的患者。研究的主要结果是总生存率，次要结果是综合不良事件。综合不良事件定义为死亡、主动脉事件和感染性不良事件的组合：共有 28 名患者纳入分析，其中 13 名患者患有霉菌性胸主动脉瘤，12 名患者患有主动脉支气管瘘，3 名患者患有主动脉肠瘘。7 名患者（25%）接受了额外手术（脓肿引流术，6 例；全食道切除术，1 例）。平均随访时间为（30.0 ± 33.9）个月。1 年和 5 年存活率分别为 85.7% 和 67.9%。1年和5年无主动脉相关并发症生存率分别为64.3%和42.9%。单变量分析显示，主动脉支气管瘘的存在与较高的综合不良事件风险相关（几率比 [OR] = 11，P = 0.04）：结论：TEVAR可能是一种治疗感染性胸主动脉疾病的有效方法。结论：TEVAR可能是治疗感染性胸主动脉疾病的一种有前途的方法。在感染性病变中，ABF被认为是晚期预后不佳的病变。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Vascular and Interventional Radiology 医学-核医学

CiteScore

4.30

自引率

10.30%

发文量

942

审稿时长

90 days

期刊介绍： JVIR, published continuously since 1990, is an international, monthly peer-reviewed interventional radiology journal. As the official journal of the Society of Interventional Radiology, JVIR is the peer-reviewed journal of choice for interventional radiologists, radiologists, cardiologists, vascular surgeons, neurosurgeons, and other clinicians who seek current and reliable information on every aspect of vascular and interventional radiology. Each issue of JVIR covers critical and cutting-edge medical minimally invasive, clinical, basic research, radiological, pathological, and socioeconomic issues of importance to the field.