Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts

Objective: Mycotic/infective native aortic aneurysms (INAA) are managed heterogeneously. In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. EVAR necessitated secondary open repair, but its limited use in this report did not allow conclusions to be drawn. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Touma, Joseph [verfasserIn] Couture, Thibault [verfasserIn] Davaine, Jean-Michel [verfasserIn] de Boissieu, Paul [verfasserIn] Oubaya, Nadia [verfasserIn] Michel, Cassandre [verfasserIn] Cochennec, Frédéric [verfasserIn] Chiche, Laurent [verfasserIn] Desgranges, Pascal [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	Allografts Infected aneurysm Mycotic aneurysm

Übergeordnetes Werk:	Enthalten in: European journal of vascular and endovascular surgery - New York, NY : Elsevier, 1995, 63, Seite 475-483
Übergeordnetes Werk:	volume:63 ; pages:475-483

DOI / URN:	10.1016/j.ejvs.2021.10.041

Katalog-ID:	ELV007591551

Internformat


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100	1		\|a Touma, Joseph \|e verfasserin \|4 aut
245	1	0	\|a Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts
264		1	\|c 2021
336			\|a nicht spezifiziert \|b zzz \|2 rdacontent
337			\|a Computermedien \|b c \|2 rdamedia
338			\|a Online-Ressource \|b cr \|2 rdacarrier
520			\|a Objective: Mycotic/infective native aortic aneurysms (INAA) are managed heterogeneously. In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. EVAR necessitated secondary open repair, but its limited use in this report did not allow conclusions to be drawn.
650		4	\|a Allografts
650		4	\|a Infected aneurysm
650		4	\|a Mycotic aneurysm
700	1		\|a Couture, Thibault \|e verfasserin \|4 aut
700	1		\|a Davaine, Jean-Michel \|e verfasserin \|4 aut
700	1		\|a de Boissieu, Paul \|e verfasserin \|4 aut
700	1		\|a Oubaya, Nadia \|e verfasserin \|4 aut
700	1		\|a Michel, Cassandre \|e verfasserin \|4 aut
700	1		\|a Cochennec, Frédéric \|e verfasserin \|4 aut
700	1		\|a Chiche, Laurent \|e verfasserin \|4 aut
700	1		\|a Desgranges, Pascal \|e verfasserin \|4 aut
773	0	8	\|i Enthalten in \|t European journal of vascular and endovascular surgery \|d New York, NY : Elsevier, 1995 \|g 63, Seite 475-483 \|h Online-Ressource \|w (DE-627)320444872 \|w (DE-600)2005354-X \|w (DE-576)104558539 \|x 1532-2165 \|7 nnns
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936	b	k	\|a 44.85 \|j Kardiologie \|j Angiologie
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allfields	10.1016/j.ejvs.2021.10.041 doi (DE-627)ELV007591551 (ELSEVIER)S1078-5884(21)00826-1 DE-627 ger DE-627 rda eng 610 DE-600 44.85 bkl Touma, Joseph verfasserin aut Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Mycotic/infective native aortic aneurysms (INAA) are managed heterogeneously. In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. EVAR necessitated secondary open repair, but its limited use in this report did not allow conclusions to be drawn. Allografts Infected aneurysm Mycotic aneurysm Couture, Thibault verfasserin aut Davaine, Jean-Michel verfasserin aut de Boissieu, Paul verfasserin aut Oubaya, Nadia verfasserin aut Michel, Cassandre verfasserin aut Cochennec, Frédéric verfasserin aut Chiche, Laurent verfasserin aut Desgranges, Pascal verfasserin aut Enthalten in European journal of vascular and endovascular surgery New York, NY : Elsevier, 1995 63, Seite 475-483 Online-Ressource (DE-627)320444872 (DE-600)2005354-X (DE-576)104558539 1532-2165 nnns volume:63 pages:475-483 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 44.85 Kardiologie Angiologie AR 63 475-483
spelling	10.1016/j.ejvs.2021.10.041 doi (DE-627)ELV007591551 (ELSEVIER)S1078-5884(21)00826-1 DE-627 ger DE-627 rda eng 610 DE-600 44.85 bkl Touma, Joseph verfasserin aut Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Mycotic/infective native aortic aneurysms (INAA) are managed heterogeneously. In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. EVAR necessitated secondary open repair, but its limited use in this report did not allow conclusions to be drawn. Allografts Infected aneurysm Mycotic aneurysm Couture, Thibault verfasserin aut Davaine, Jean-Michel verfasserin aut de Boissieu, Paul verfasserin aut Oubaya, Nadia verfasserin aut Michel, Cassandre verfasserin aut Cochennec, Frédéric verfasserin aut Chiche, Laurent verfasserin aut Desgranges, Pascal verfasserin aut Enthalten in European journal of vascular and endovascular surgery New York, NY : Elsevier, 1995 63, Seite 475-483 Online-Ressource (DE-627)320444872 (DE-600)2005354-X (DE-576)104558539 1532-2165 nnns volume:63 pages:475-483 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 44.85 Kardiologie Angiologie AR 63 475-483
allfields_unstemmed	10.1016/j.ejvs.2021.10.041 doi (DE-627)ELV007591551 (ELSEVIER)S1078-5884(21)00826-1 DE-627 ger DE-627 rda eng 610 DE-600 44.85 bkl Touma, Joseph verfasserin aut Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Mycotic/infective native aortic aneurysms (INAA) are managed heterogeneously. In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. EVAR necessitated secondary open repair, but its limited use in this report did not allow conclusions to be drawn. Allografts Infected aneurysm Mycotic aneurysm Couture, Thibault verfasserin aut Davaine, Jean-Michel verfasserin aut de Boissieu, Paul verfasserin aut Oubaya, Nadia verfasserin aut Michel, Cassandre verfasserin aut Cochennec, Frédéric verfasserin aut Chiche, Laurent verfasserin aut Desgranges, Pascal verfasserin aut Enthalten in European journal of vascular and endovascular surgery New York, NY : Elsevier, 1995 63, Seite 475-483 Online-Ressource (DE-627)320444872 (DE-600)2005354-X (DE-576)104558539 1532-2165 nnns volume:63 pages:475-483 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 44.85 Kardiologie Angiologie AR 63 475-483
allfieldsGer	10.1016/j.ejvs.2021.10.041 doi (DE-627)ELV007591551 (ELSEVIER)S1078-5884(21)00826-1 DE-627 ger DE-627 rda eng 610 DE-600 44.85 bkl Touma, Joseph verfasserin aut Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Mycotic/infective native aortic aneurysms (INAA) are managed heterogeneously. In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. EVAR necessitated secondary open repair, but its limited use in this report did not allow conclusions to be drawn. Allografts Infected aneurysm Mycotic aneurysm Couture, Thibault verfasserin aut Davaine, Jean-Michel verfasserin aut de Boissieu, Paul verfasserin aut Oubaya, Nadia verfasserin aut Michel, Cassandre verfasserin aut Cochennec, Frédéric verfasserin aut Chiche, Laurent verfasserin aut Desgranges, Pascal verfasserin aut Enthalten in European journal of vascular and endovascular surgery New York, NY : Elsevier, 1995 63, Seite 475-483 Online-Ressource (DE-627)320444872 (DE-600)2005354-X (DE-576)104558539 1532-2165 nnns volume:63 pages:475-483 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 44.85 Kardiologie Angiologie AR 63 475-483
allfieldsSound	10.1016/j.ejvs.2021.10.041 doi (DE-627)ELV007591551 (ELSEVIER)S1078-5884(21)00826-1 DE-627 ger DE-627 rda eng 610 DE-600 44.85 bkl Touma, Joseph verfasserin aut Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective: Mycotic/infective native aortic aneurysms (INAA) are managed heterogeneously. In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. EVAR necessitated secondary open repair, but its limited use in this report did not allow conclusions to be drawn. Allografts Infected aneurysm Mycotic aneurysm Couture, Thibault verfasserin aut Davaine, Jean-Michel verfasserin aut de Boissieu, Paul verfasserin aut Oubaya, Nadia verfasserin aut Michel, Cassandre verfasserin aut Cochennec, Frédéric verfasserin aut Chiche, Laurent verfasserin aut Desgranges, Pascal verfasserin aut Enthalten in European journal of vascular and endovascular surgery New York, NY : Elsevier, 1995 63, Seite 475-483 Online-Ressource (DE-627)320444872 (DE-600)2005354-X (DE-576)104558539 1532-2165 nnns volume:63 pages:475-483 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2336 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4393 GBV_ILN_4700 44.85 Kardiologie Angiologie AR 63 475-483
language	English
source	Enthalten in European journal of vascular and endovascular surgery 63, Seite 475-483 volume:63 pages:475-483
sourceStr	Enthalten in European journal of vascular and endovascular surgery 63, Seite 475-483 volume:63 pages:475-483
format_phy_str_mv	Article
bklname	Kardiologie Angiologie
institution	findex.gbv.de
topic_facet	Allografts Infected aneurysm Mycotic aneurysm
dewey-raw	610
isfreeaccess_bool	false
container_title	European journal of vascular and endovascular surgery
authorswithroles_txt_mv	Touma, Joseph @@aut@@ Couture, Thibault @@aut@@ Davaine, Jean-Michel @@aut@@ de Boissieu, Paul @@aut@@ Oubaya, Nadia @@aut@@ Michel, Cassandre @@aut@@ Cochennec, Frédéric @@aut@@ Chiche, Laurent @@aut@@ Desgranges, Pascal @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
hierarchy_top_id	320444872
dewey-sort	3610
id	ELV007591551
language_de	englisch
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In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. 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author	Touma, Joseph
spellingShingle	Touma, Joseph ddc 610 bkl 44.85 misc Allografts misc Infected aneurysm misc Mycotic aneurysm Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts
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topic_title	610 DE-600 44.85 bkl Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts Allografts Infected aneurysm Mycotic aneurysm
topic	ddc 610 bkl 44.85 misc Allografts misc Infected aneurysm misc Mycotic aneurysm
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title	Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts
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title_full	Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts
author_sort	Touma, Joseph
journal	European journal of vascular and endovascular surgery
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author_browse	Touma, Joseph Couture, Thibault Davaine, Jean-Michel de Boissieu, Paul Oubaya, Nadia Michel, Cassandre Cochennec, Frédéric Chiche, Laurent Desgranges, Pascal
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doi_str_mv	10.1016/j.ejvs.2021.10.041
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title_sort	mycotic/infective native aortic aneurysms: results after preferential use of open surgery and arterial allografts
title_auth	Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts
abstract	Objective: Mycotic/infective native aortic aneurysms (INAA) are managed heterogeneously. In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. EVAR necessitated secondary open repair, but its limited use in this report did not allow conclusions to be drawn.
abstractGer	Objective: Mycotic/infective native aortic aneurysms (INAA) are managed heterogeneously. In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. EVAR necessitated secondary open repair, but its limited use in this report did not allow conclusions to be drawn.
abstract_unstemmed	Objective: Mycotic/infective native aortic aneurysms (INAA) are managed heterogeneously. In the context of disparate literature, this study aimed to assess the outcomes of INAA surgical management and provide comprehensive data in alignment with recent suggestions for reporting standards.Methods: A retrospective review of patients presenting with INAA from September 2002 to March 2020 at two institutions was conducted. In hospital mortality, 90 day mortality, overall mortality, and infection related complications (IRCs) were the study endpoints. Overall survival and IRC free survival were estimated, and predictors of mortality tested using uni- and multivariable analyses.Results: Seventy patients (60 men [86%], median age 68 years [range 59 – 76 years]) were included. Twenty (29%) were ruptured at presentation. INAA location was thoracic in 11 (16%) cases, thoraco-abdominal in seven (10%), and abdominal in 50 (71%). Half of the abdominal INAAs were suprarenal. Two INAAs were concomitantly abdominal and thoracic. Pathogens were identified in 83%. The bacterial spectrum was scattered, with rare Salmonella species (n = 6; 9%). Open surgical repair was performed in 66 (94%) patients, including five conversions of initially attempted endovascular grafts (EVAR), three hybrid procedures, and one palliative EVAR. Vascular substitutes were cryopreserved arterial allografts (n = 67; 96%), prosthesis (n = 2), or femoral veins (n = 1). Kaplan–Meier estimates of overall survival at 30 and 90 days were 87% (95% confidence interval [CI] 76.6 – 93.0) and 71.7% (95% CI 59.2 – 80.9), respectively. The overall in hospital mortality rate was 27.9% (95% CI 1.8 – 66.5). IRCs occurred in seven (10%) patients. The median follow up period was 26.5 months (range 13.0–66.0 months). Chronic kidney disease (CKD) was independently related to in hospital mortality (odds ratio [OR] 20.7, 95% CI 1.8 – 232.7). American Society of Anesthesiologists score of 3 (OR 6.0, 95% CI 1.1 – 33.9), 4 (OR 14.9, 95% CI 1.7 – 129.3), and CKD (OR 32.0, 95% CI 1.2 – 821.5) were related to 90 day mortality.Conclusion: Surgical INAA management has significant mortality and a low re-infection rate. EVAR necessitated secondary open repair, but its limited use in this report did not allow conclusions to be drawn.
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title_short	Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts
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author2	Couture, Thibault Davaine, Jean-Michel de Boissieu, Paul Oubaya, Nadia Michel, Cassandre Cochennec, Frédéric Chiche, Laurent Desgranges, Pascal
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doi_str	10.1016/j.ejvs.2021.10.041
up_date	2024-07-06T16:47:29.190Z
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Mycotic/Infective Native Aortic Aneurysms: Results After Preferential Use of Open Surgery and Arterial Allografts

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