Outcomes of infective aneurysm repairs in the New Zealand thoracic stent database.

BACKGROUND

Infective thoracic aneurysms are rare and have a poor prognosis. In the past, these have been managed surgically with adjunctive antibiotic therapy. Endoluminal repair is a relatively new treatment option which may be associated with lower morbidity and mortality.

METHODS

The New Zealand Thoracic Aorta Stent graft registry was interrogated between December 2001 and September 2009, selecting all patients with endoluminal repair of infective thoracic aortic aneurysms.

RESULTS

Out of 184 patients on the database, four (2.2%) patients (male = 3, median age = 72) underwent endoluminal repair of an infective thoracic aortic aneurysm. The aneurysm was successfully excluded at the time of the procedure in all patients. There was a low incidence of post-procedural complications including atrial fibrillation (n = 1), pneumonia with haemoptysis (n = 1), urinary retention (n = 1) and access site seroma (n = 1). Time to discharge was mean of 26.5 days, median 22.5 days (8–53 days). One of the four patients is still alive and well at the time of reporting. Of the remaining three patients, mean survival is 486 days, median 374 days (336–748 days).

CONCLUSIONS

Endoluminal repair is a treatment option for infective thoracic aneurysms, but the durability is unknown. Due to the rareness of the condition, a randomized clinical trial is unlikely to succeed. National registries such as the New Zealand Thoracic Aortic Stent provide useful information regarding this.