Evaluation of Effectiveness of Thoracic Endovascular Treatment for Infectious Aortic Diseases.

Autor: Kato H; Depratment of Radiology, Mie University Hospital., Kato N; Depratment of Radiology, Mie University Hospital. Electronic address: nkato@medic.mie-u.ac.jp., Ouchi T; Depratment of Radiology, Mie University Hospital., Higashigawa T; Depratment of Radiology, Mie University Hospital., Nakajima K; Department of Radiology, Ise Red Cross Hospital., Chino S; Department of Radiology, Ise Red Cross Hospital., Ito H; Depratment of Cardiovascular Surgery, Mie University Hospital., Tokui T; Department of Thoracic Surgery, Ise Red Cross Hospital., Mizumoto T; Department of Cardiovascular Surgery, Anjo Kosei Hospital., Oue K; Department of Cardiovascular Surgery, Kochi Health Science Center., Ichikawa Y; Depratment of Radiology, Mie University Hospital., Sakuma H; Depratment of Radiology, Mie University Hospital.
Jazyk: angličtina
Zdroj: Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2024 Oct 18. Date of Electronic Publication: 2024 Oct 18.
DOI: 10.1016/j.jvir.2024.10.012
Abstrakt: Purpose: The aim of study is to investigate the efficacy of thoracic endovascular aortic repair for infectious aortic diseases.
Materials and Methods: Patients who underwent thoracic endovascular repair for infectious aortic diseases including mycotic thoracic aortic aneurysm, aorto-bronchial fistula and aorto-enteric fistula from December 2011 to October 2022 at four institutions were retrospectively studied. The primary outcome of the study was overall survival, whereas the secondary outcome was comprehensive adverse event. 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 mycotic thoracic aortic aneurysms, 12 having aorto-bronchial fistulas, and 3 having aorto-enteric fistulas. Seven patients (25%) underwent additional procedures (abscess drainage, 6 cases; total esophagectomy, 1 case). The mean follow-up period was 30.0 ± 33.9 months. 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 aorto-bronchial fistula was associated with a higher risk of comprehensive adverse events (odds ratio [OR] = 11, P = 0.04).
Conclusion: TEVAR might be a promising treatment for infectious thoracic aortic diseases. Among the infectious pathologies, ABF was considered ominous in terms of late outcomes.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE