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Verfasst von:Hoffmann-Wieker, Carola Marie [VerfasserIn]   i
 Rengier, Fabian [VerfasserIn]   i
 Böckler, Dittmar [VerfasserIn]   i
 Geisbüsch, Philipp [VerfasserIn]   i
Titel:Long-term results after open repair of inflammatory infrarenal aortic aneurysms
Verf.angabe:Carola M. Wieker, Philipp von Stein, Claudio Bianchini Massoni, Fabian Rengier, Dittmar Böckler, and Philipp Geisbüsch
Jahr:2019
Jahr des Originals:2018
Umfang:8 S.
Fussnoten:Available online 28 June 2018 ; Gesehen am 03.04.2019
Titel Quelle:Enthalten in: Journal of vascular surgery
Ort Quelle:Amsterdam [u.a.] : Elsevier, 1984
Jahr Quelle:2019
Band/Heft Quelle:69(2019), 2, Seite 440-447
ISSN Quelle:1097-6809
Abstract:Objective - The objective of this study was to investigate the long-term outcome after open repair of inflammatory infrarenal aortic aneurysms. - Methods - A total of 62 patients (mean age, 68.9 ± 8.8 years; 91.9% male) undergoing open surgery for inflammatory aortic aneurysm from 1995 until 2014 in a high-volume vascular center were retrospectively evaluated. The patients' demographics, preoperative and postoperative clinical characteristics, imaging measurements, and procedural data were collected. Study end points were preoperative and postoperative sac diameter, evolution of periaortic fibrosis and development of hydroureteronephrosis detected by computed tomography (CT) scan, and mortality and morbidity after 30 days and at the time of maximum follow-up. - Results - The mean abdominal aortic aneurysm diameter was 67.3 ± 16.7 mm. A total of 30 patients (48.4%) were asymptomatic, 27 patients (43.5%) were symptomatic, and 5 patients (8.1%) were treated for ruptured aneurysm. In 25 patients (40.3%), an aorta-aortic tube graft was implanted; in 37 patients (59.7%), an aortic bifurcation graft was used. Median operating time was 208 minutes (range, 83-519 minutes). Median aortic clamping time was 31 minutes (range, 14-90 minutes); in 25 patients (40.3%), suprarenal aortic cross-clamping was necessary. Hydroureteronephrosis was preoperatively diagnosed by CT scan in 16 patients (25.8%), with the need for a ureteral stent in 11 patients (17.7%). Aneurysm- and procedure-associated 30-day mortality was 11.3% (n = 7), with septic multiple organ failure in four patients and cardiac arrest in three patients. The overall perioperative complication rate was 33.9% (n = 21 patients). Median follow-up was 71.0 months (range, 0.2-231.6 months). At 1 year, 2 years, 4 years, and 6 years, overall survival was 83.4%, 79.6%, 79.6%, and 72.6%, respectively. Six patients (9.7%) required a reintervention during follow-up, predominantly aneurysm related and caused by aortoenteric fistula and graft infection (three of five patients). Median maximum thickness of preoperative perianeurysmal inflammation on CT was 10 mm (range, 2-22 mm), which decreased in 15 of 16 (94%) patients with available postoperative CT scans. Postoperative median thickness of perianeurysmal inflammation on CT was 6 mm (range, 0-13 mm). Hydroureteronephrosis persisted in two of nine (22.2%) patients at the end of follow-up. - Conclusions - Surgery in patients with inflammatory abdominal aortic aneurysms is associated with a substantial amount of perioperative complications. After surgery, the perianeurysmal inflammation decreases in most patients on follow-up CT. However, because the inflammatory process does not totally resolve, patients require lifelong surveillance for hydroureteronephrosis and development of aortoenteric fistulas.
DOI:doi:10.1016/j.jvs.2018.04.048
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: https://doi.org/10.1016/j.jvs.2018.04.048
 Volltext: http://www.sciencedirect.com/science/article/pii/S0741521418310565
 DOI: https://doi.org/10.1016/j.jvs.2018.04.048
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:Inflammatory aortic aneurysm
 Open repair
 Outcome
 Survival
K10plus-PPN:1662746563
Verknüpfungen:→ Zeitschrift

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