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腔内修复治疗感染性主动脉瘤可获得良好的中期结果和瘤囊消退。

Endovascular repair of mycotic aortic aneurysms confers good medium-term outcomes and aneurysmal sac resolution.

机构信息

Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore.

Vascular and Interventional Radiology, Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore.

出版信息

Singapore Med J. 2022 May;63(5):263-267. doi: 10.11622/smedj.2020165. Epub 2020 Dec 2.

Abstract

INTRODUCTION

Mycotic aortic aneurysm (MAA) is a life-threatening condition. Endovascular repair (EVAR) of aortic aneurysms has been found to be a safe and effective alternative to open repair. We aimed to present the short- to medium-term outcomes for EVAR of MAA in our cohort.

METHODS

We conducted a retrospective study of 23 consecutive patients with MAA who underwent EVAR in our hospital from January 2008 to July 2017.

RESULTS

The mean age of our study population was 62 years. The mean aneurysmal size was 3.2 cm. Abdominal MAAs (n = 16, 70%) were the most common, followed by thoracic MAAs (n = 4, 17%). There was no 30-day mortality in our cohort. Endoleak (Types 1, 3, 4) was detected in 3 (13%) cases. At the one-month surveillance computed tomography aortogram, all patients had a reduction in aneurysmal size and 5 (22%) had complete aneurysmal sac resolution. 7 (30%) patients had sac resolution at six months and 8 (35%) patients, at 12 months. The overall survival was 91%, 80% and 61% at one, 12 and 60 months, respectively.

CONCLUSION

EVAR is a feasible and durable method for the repair of MAA, with a five-year overall survival of 61%. All patients in our study had a reduction in aneurysmal size at one month, with 65% having complete aneurysmal sac resolution by 12 months.

摘要

简介

真菌性主动脉瘤(MAA)是一种危及生命的疾病。血管内修复(EVAR)已被证明是治疗主动脉瘤的一种安全有效的替代方法。我们旨在展示我们队列中 MAA 的 EVAR 的短期至中期结果。

方法

我们对 2008 年 1 月至 2017 年 7 月期间在我院接受 EVAR 的 23 例 MAA 连续患者进行了回顾性研究。

结果

我们研究人群的平均年龄为 62 岁。平均瘤径为 3.2 厘米。腹部 MAA(n = 16,70%)最常见,其次是胸 MAA(n = 4,17%)。我们的队列中没有 30 天死亡率。在 3 例(13%)患者中检测到内漏(类型 1、3、4)。在一个月的监测计算机断层血管造影时,所有患者的瘤径均缩小,5 例(22%)患者的瘤囊完全消退。7 例(30%)患者在 6 个月时瘤囊消退,8 例(35%)患者在 12 个月时瘤囊消退。1、12 和 60 个月时的总体生存率分别为 91%、80%和 61%。

结论

EVAR 是治疗 MAA 的一种可行且持久的方法,5 年总生存率为 61%。我们研究中的所有患者在一个月时瘤径均缩小,65%的患者在 12 个月时瘤囊完全消退。

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本文引用的文献

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Therapeutic opinion on endovascular repair for mycotic aortic aneurysm.真菌性主动脉瘤血管内修复的治疗意见
Ann Vasc Surg. 2014 Apr;28(3):579-89. doi: 10.1016/j.avsg.2013.07.009. Epub 2014 Jan 6.
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