Nationwide study of the treatment of mycotic abdominal aortic aneurysms comparing open and endovascular repair in The Netherlands

Mycotic aneurysms of the abdominal aorta (MAAA) can be treated by open repair (OR) or endovascular aneurysm repair (EVAR). This nationwide study provides an overview of the situation of MAAA treatment in The Netherlands in 2016. A retrospective cohort study was conducted with all centers that regist...

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Published in:	Journal of vascular surgery Vol. 72; no. 2; pp. 531 - 540
Main Authors:	Dang, Quan, Statius van Eps, Randolph G., Wever, Jan J., Van den Akker, P.J., Akkersdijk, G.P., Baal, J.G., Balm, R., Bender, M.H., Bendermacher, B.L., van den Berg, M., Beuk, R.J., Bleker, R.J., Bodegom, M.E., Boll, A.P., Booster, M.H., Borger van der Burg, B.L., de Borst, G.J., Breek, J.C., Brehm, V., Brinckman, M.J., Brom, H.L., de Bruijn, M.T., Brummel, P., Buijk, S.E., Buscher, H.C., den Butter, G., Castenmiller, P.H., Cazander, G., Coveliers, H.M., Derom, A.F., Dinkelman, M.K., Elsman, B.H., van der Elst, A., van Eps, R.G., Faber, M.J., Glade, G.J., de Groot, H.G., van den Haak, R.F., Hajer, G.F., Hedeman Joosten, P.P., Heyligers, J.M., Ho, G.H., Hoffmann, W.H., Hollander, E.J., Idu, M.M., Jacobs, M.J., Jongkind, V., Kapma, M.R., Koedam, N.A., Koning, G.G., Koning, O.H., Krasznai, A.G., Leijdekkers, V.J., Lijkwan, M.A., Liqui Lung, P.F., Meerwaldt, R., Mees, B.M., Metz, R., Montauban van Swijndregt, Y.C., Morak, M.J., Nagesser, S.K., van Nieuwenhuizen, R.C., van Petersen, A.S., Pierie, M.E., Ploeg, A.J., Ponfoort, E.D., ten Raa, S., van Sambeek, M.R., Samyn, M.G., van ’t Sant, H.P., Schepers, A., Schlejen, P.M., Schlosser, F.J., Schouten, O., Schreve, M.A., Schurink, G.W., Sikkink, C.J., Smeets, H.J., Smeets, L., de Smet, A.A., Stigter, H., Strating, R.P., Thijsse, W.J., van Tongeren, R.B., Tordoir, J.H., Tournoij, E., Veger, H.T., Vlijmen - van Keulen, C.J., Voesten, H.G., Vos, A.W., de Vos, B., Vriens, P.W., de Vries, M., van Walraven, L.A., van Weel, V., Welten, R.J., Wever, J.J., Wittens, C.H., Wolf-de Jonge, I.C., Yazar, O.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-08-2020
Subjects:	Abdominal aneurysm Clinical audit Endovascular aneurysm repair Infectious Mycotic Clinical audit Endovascular aneurysm repair Infectious Abdominal aneurysm Mycotic
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Summary:	Mycotic aneurysms of the abdominal aorta (MAAA) can be treated by open repair (OR) or endovascular aneurysm repair (EVAR). This nationwide study provides an overview of the situation of MAAA treatment in The Netherlands in 2016. A retrospective cohort study was conducted with all centers that registered aortic abdominal aneurysms in the Dutch Surgical Aneurysm Audit in 2016. Questionnaires on 1-year outcomes were sent to all centers that treated patients with MAAA. The primary aim was to determine 30-day and 1-year mortality and morbidity of OR- and EVAR-treated patients. Morbidity was determined by the need for reoperations and the number of readmissions to the hospital. Twenty-six MAAA were detected in the Dutch Surgical Aneurysm Audit database of 2016, resulting in an incidence of 0.7% of all registered abdominal aortic aneurysms. The 30-day mortality for OR and EVAR treated patients was 1 in 13 and 0 in 13, respectively. Major and minor reinterventions within 30 days were needed for two (one OR and one EVAR) and two (one OR and one EVAR) patients, respectively. Two patients (15.4%) in the OR group and one patient (7.7%) in the EVAR group were readmitted to hospital within 30 days. In total, 1-year outcomes of 23 patients were available. In the OR group, one patient (9.1%) died in the first postoperative year. There was one major reintervention (removal of endoprosthesis and spiralvein reconstruction) in the EVAR group. Two patients (18.2%) treated with OR and two (16.7%) treated with EVAR required a minor reintervention. In both groups, four patients (OR, 36.4%; EVAR, 33.3%) were readmitted to hospital within 1 year postoperatively. Both OR- and EVAR-treated patients show acceptable clinical outcomes after 30 days and at the 1-year follow-up. Depending on the clinical course of the patient, EVAR may be considered in the management of this disease.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0741-5214 1097-6809
DOI:	10.1016/j.jvs.2019.09.060