Response Findings after Treatment and Outcomes on CT after Endovascular Repair of Mycotic Aortic Aneurysm.
J Vasc Interv Radiol 2020;
31:969-976. [PMID:
32414571 DOI:
10.1016/j.jvir.2019.12.803]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/12/2019] [Accepted: 12/30/2019] [Indexed: 10/24/2022] Open
Abstract
PURPOSE
To demonstrate post-treatment computed tomography (CT) findings and outcomes of endovascular aortic repair (EVAR) for mycotic aortic aneurysm (MAA).
MATERIALS AND METHODS
Clinical data of patients with MAA who underwent EVAR from June 2010 to December 2017 were retrospectively reviewed. A total of 22 patients were included (19 men and 3 women). The periaortic features of the MAA regression after EVAR were graded and evaluated by follow-up CT.
RESULTS
The median follow-up was 36.5 months (range, 0.5-97 months.). The cumulative survival rate at 1 month, 6 months, 1 year, and 5 years was 95.5%, 86.4%, 81.6%, and 73.4%, respectively. The early and late infection-related complication (IRC) rate was 18.2% and 13.6%, respectively. One patient died within 1 month from severe acidosis and shock. Of the other patients, the median time to stable response of the MAA was 6 months (range, 3-36 months). Fourteen patients (66.7%) showed early response of the MAA, while 7 patients (33.3%) showed delayed response. A significant association was observed between delayed response and late IRCs (P = .026).
CONCLUSIONS
The post-EVAR periaortic features on follow-up CT aid in monitoring the treatment response of the MAA. Early response of the MAA was associated with a low rate of late IRCs and might aid in adjusting the antibiotic duration after the patient has achieved complete or nearly complete regression of the MAA.
Collapse