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Article: Endovascular stent graft repair for infected thoracic aortic pseudoaneurysms-a durable option?

TitleEndovascular stent graft repair for infected thoracic aortic pseudoaneurysms-a durable option?
Authors
Issue Date2006
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jvs
Citation
Journal Of Vascular Surgery, 2006, v. 44 n. 4, p. 701-705 How to Cite?
AbstractObjective: Open surgical repair for infected thoracic aortic pseudoaneurysms carries significant mortality and morbidity. Endovascular stent graft repair has been our preferred approach, although its role remains controversial because persistent infection is always a concern. We aimed to assess the efficacy and durability of endovascular stent graft repair in these patients. Methods: Between August 2000 and November 2005, seven consecutive patients with eight infected pseudoaneurysms of the thoracic aorta were treated with endovascular stent graft repair. Patients were diagnosed based on a typical appearance of an infected pseudoaneurysm on imaging together with a positive bacteriology culture or clinical evidence of sepsis. The follow-up protocol included regular clinical examination, hematologic tests, and computed tomography scans. Results: There were six men and one woman with a median age of 68 years at operation. Three patients presented with an aortoenteric fistula. The operations were performed in the operating room with the image guidance of a mobile C-arm. Endovascular stent grafts were deployed successfully in all patients, with complete exclusion of the pseudoaneurysms. Intravenous antibiotics were continued for 1 to 6 weeks and followed by lifelong maintenance oral antibiotics. The median hospital stay was 27 days, with no hospital deaths. No paraplegia or other major complications occurred. Two patients with aortoesophageal fistula where the fistula tracts were persistent died during follow-up. The other five patients remained well, with no evidence of graft infection at a median follow-up of 34 months. A significant reduction in the diameter of the pseudoaneurysm (>5 mm) was noted on computed tomography scans after 12 months. Conclusion: Endovascular stent graft repair is effective and may be a durable option for infected pseudoaneurysms of the thoracic aorta. © 2006 The Society for Vascular Surgery.
Persistent Identifierhttp://hdl.handle.net/10722/147684
ISSN
2015 Impact Factor: 3.454
2015 SCImago Journal Rankings: 2.115
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorTing, ACWen_HK
dc.contributor.authorCheng, SWKen_HK
dc.contributor.authorHo, Pen_HK
dc.contributor.authorPoon, JTCen_HK
dc.date.accessioned2012-05-29T06:07:56Z-
dc.date.available2012-05-29T06:07:56Z-
dc.date.issued2006en_HK
dc.identifier.citationJournal Of Vascular Surgery, 2006, v. 44 n. 4, p. 701-705en_HK
dc.identifier.issn0741-5214en_HK
dc.identifier.urihttp://hdl.handle.net/10722/147684-
dc.description.abstractObjective: Open surgical repair for infected thoracic aortic pseudoaneurysms carries significant mortality and morbidity. Endovascular stent graft repair has been our preferred approach, although its role remains controversial because persistent infection is always a concern. We aimed to assess the efficacy and durability of endovascular stent graft repair in these patients. Methods: Between August 2000 and November 2005, seven consecutive patients with eight infected pseudoaneurysms of the thoracic aorta were treated with endovascular stent graft repair. Patients were diagnosed based on a typical appearance of an infected pseudoaneurysm on imaging together with a positive bacteriology culture or clinical evidence of sepsis. The follow-up protocol included regular clinical examination, hematologic tests, and computed tomography scans. Results: There were six men and one woman with a median age of 68 years at operation. Three patients presented with an aortoenteric fistula. The operations were performed in the operating room with the image guidance of a mobile C-arm. Endovascular stent grafts were deployed successfully in all patients, with complete exclusion of the pseudoaneurysms. Intravenous antibiotics were continued for 1 to 6 weeks and followed by lifelong maintenance oral antibiotics. The median hospital stay was 27 days, with no hospital deaths. No paraplegia or other major complications occurred. Two patients with aortoesophageal fistula where the fistula tracts were persistent died during follow-up. The other five patients remained well, with no evidence of graft infection at a median follow-up of 34 months. A significant reduction in the diameter of the pseudoaneurysm (>5 mm) was noted on computed tomography scans after 12 months. Conclusion: Endovascular stent graft repair is effective and may be a durable option for infected pseudoaneurysms of the thoracic aorta. © 2006 The Society for Vascular Surgery.en_HK
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/jvsen_HK
dc.relation.ispartofJournal of Vascular Surgeryen_HK
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshAneurysm, False - Radiography - Surgeryen_US
dc.subject.meshAneurysm, Infected - Radiography - Surgeryen_US
dc.subject.meshAortic Aneurysm, Thoracic - Radiography - Surgeryen_US
dc.subject.meshBlood Vessel Prosthesis Implantation - Instrumentationen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshProsthesis Designen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshStentsen_US
dc.subject.meshTomography, X-Ray Computeden_US
dc.subject.meshTreatment Outcomeen_US
dc.titleEndovascular stent graft repair for infected thoracic aortic pseudoaneurysms-a durable option?en_HK
dc.typeArticleen_HK
dc.identifier.emailCheng, SWK: wkcheng@hkucc.hku.hken_HK
dc.identifier.emailPoon, JTC: tcjensen@hkucc.hku.hken_HK
dc.identifier.authorityCheng, SWK=rp00374en_HK
dc.identifier.authorityPoon, JTC=rp01603en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.jvs.2006.05.055en_HK
dc.identifier.pmid16930927-
dc.identifier.scopuseid_2-s2.0-33748957994en_HK
dc.identifier.hkuros123731-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33748957994&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume44en_HK
dc.identifier.issue4en_HK
dc.identifier.spage701en_HK
dc.identifier.epage705en_HK
dc.identifier.isiWOS:000240960000003-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridTing, ACW=7102858552en_HK
dc.identifier.scopusauthoridCheng, SWK=7404684779en_HK
dc.identifier.scopusauthoridHo, P=24469553100en_HK
dc.identifier.scopusauthoridPoon, JTC=7005903722en_HK

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