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Endovascular treatment of mycotic aortic aneurysms: a European multicenter study

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Endovascular treatment of mycotic aortic aneurysms: a European multicenter study. / Sörelius, Karl; Mani, Kevin; Björck, Martin; Sedivy, Petr; Wahlgren, Carl-Magnus; Taylor, Peter; Clough, Rachel E; Lyons, Oliver; Thompson, Matt; Brownrigg, Jack; Ivancev, Krassi; Davis, Meryl; Jenkins, Michael P; Jaffer, Usman; Bown, Matt; Rancic, Zoran; Mayer, Dieter; Brunkwall, Jan; Gawenda, Michael; Kölbel, Tilo; Jean-Baptiste, Elixène; Moll, Frans; Berger, Paul; Liapis, Christos D; Moulakakis, Konstantinos G; Langenskiöld, Marcus; Roos, Håkan; Larzon, Thomas; Pirouzram, Artai; Wanhainen, Anders; European MAA collaborators.

In: CIRCULATION, Vol. 130, No. 24, 09.12.2014, p. 2136-2142.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Sörelius, K, Mani, K, Björck, M, Sedivy, P, Wahlgren, C-M, Taylor, P, Clough, RE, Lyons, O, Thompson, M, Brownrigg, J, Ivancev, K, Davis, M, Jenkins, MP, Jaffer, U, Bown, M, Rancic, Z, Mayer, D, Brunkwall, J, Gawenda, M, Kölbel, T, Jean-Baptiste, E, Moll, F, Berger, P, Liapis, CD, Moulakakis, KG, Langenskiöld, M, Roos, H, Larzon, T, Pirouzram, A, Wanhainen, A & European MAA collaborators 2014, 'Endovascular treatment of mycotic aortic aneurysms: a European multicenter study', CIRCULATION, vol. 130, no. 24, pp. 2136-2142. https://doi.org/10.1161/CIRCULATIONAHA.114.009481

APA

Sörelius, K., Mani, K., Björck, M., Sedivy, P., Wahlgren, C-M., Taylor, P., Clough, R. E., Lyons, O., Thompson, M., Brownrigg, J., Ivancev, K., Davis, M., Jenkins, M. P., Jaffer, U., Bown, M., Rancic, Z., Mayer, D., Brunkwall, J., Gawenda, M., ... European MAA collaborators (2014). Endovascular treatment of mycotic aortic aneurysms: a European multicenter study. CIRCULATION, 130(24), 2136-2142. https://doi.org/10.1161/CIRCULATIONAHA.114.009481

Vancouver

Sörelius K, Mani K, Björck M, Sedivy P, Wahlgren C-M, Taylor P et al. Endovascular treatment of mycotic aortic aneurysms: a European multicenter study. CIRCULATION. 2014 Dec 9;130(24):2136-2142. https://doi.org/10.1161/CIRCULATIONAHA.114.009481

Bibtex

@article{a7c00252646f40f68557642914992561,
title = "Endovascular treatment of mycotic aortic aneurysms: a European multicenter study",
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-Salmonella-positive blood cultures were more likely to die from late infection.",
keywords = "Adult, Aged, Aged, 80 and over, Aneurysm, Infected/epidemiology, Anti-Bacterial Agents/therapeutic use, Aortic Aneurysm/epidemiology, Endovascular Procedures/methods, Europe/epidemiology, Feasibility Studies, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Regression Analysis, Retrospective Studies, Surgical Wound Infection/epidemiology, Survival Rate, Time Factors, Treatment Outcome",
author = "Karl S{\"o}relius and Kevin Mani and Martin Bj{\"o}rck and Petr Sedivy and Carl-Magnus Wahlgren and Peter Taylor and Clough, {Rachel E} and Oliver Lyons and Matt Thompson and Jack Brownrigg and Krassi Ivancev and Meryl Davis and Jenkins, {Michael P} and Usman Jaffer and Matt Bown and Zoran Rancic and Dieter Mayer and Jan Brunkwall and Michael Gawenda and Tilo K{\"o}lbel and Elix{\`e}ne Jean-Baptiste and Frans Moll and Paul Berger and Liapis, {Christos D} and Moulakakis, {Konstantinos G} and Marcus Langenski{\"o}ld and H{\aa}kan Roos and Thomas Larzon and Artai Pirouzram and Anders Wanhainen and {European MAA collaborators}",
note = "{\textcopyright} 2014 American Heart Association, Inc.",
year = "2014",
month = dec,
day = "9",
doi = "10.1161/CIRCULATIONAHA.114.009481",
language = "English",
volume = "130",
pages = "2136--2142",
journal = "CIRCULATION",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "24",

}

RIS

TY - JOUR

T1 - Endovascular treatment of mycotic aortic aneurysms: a European multicenter study

AU - Sörelius, Karl

AU - Mani, Kevin

AU - Björck, Martin

AU - Sedivy, Petr

AU - Wahlgren, Carl-Magnus

AU - Taylor, Peter

AU - Clough, Rachel E

AU - Lyons, Oliver

AU - Thompson, Matt

AU - Brownrigg, Jack

AU - Ivancev, Krassi

AU - Davis, Meryl

AU - Jenkins, Michael P

AU - Jaffer, Usman

AU - Bown, Matt

AU - Rancic, Zoran

AU - Mayer, Dieter

AU - Brunkwall, Jan

AU - Gawenda, Michael

AU - Kölbel, Tilo

AU - Jean-Baptiste, Elixène

AU - Moll, Frans

AU - Berger, Paul

AU - Liapis, Christos D

AU - Moulakakis, Konstantinos G

AU - Langenskiöld, Marcus

AU - Roos, Håkan

AU - Larzon, Thomas

AU - Pirouzram, Artai

AU - Wanhainen, Anders

AU - European MAA collaborators

N1 - © 2014 American Heart Association, Inc.

PY - 2014/12/9

Y1 - 2014/12/9

N2 - 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-Salmonella-positive blood cultures were more likely to die from late infection.

AB - 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-Salmonella-positive blood cultures were more likely to die from late infection.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Aneurysm, Infected/epidemiology

KW - Anti-Bacterial Agents/therapeutic use

KW - Aortic Aneurysm/epidemiology

KW - Endovascular Procedures/methods

KW - Europe/epidemiology

KW - Feasibility Studies

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Regression Analysis

KW - Retrospective Studies

KW - Surgical Wound Infection/epidemiology

KW - Survival Rate

KW - Time Factors

KW - Treatment Outcome

U2 - 10.1161/CIRCULATIONAHA.114.009481

DO - 10.1161/CIRCULATIONAHA.114.009481

M3 - SCORING: Journal article

C2 - 25378548

VL - 130

SP - 2136

EP - 2142

JO - CIRCULATION

JF - CIRCULATION

SN - 0009-7322

IS - 24

ER -