Details der Publikation - Endovascular treatment of inflammatory infrarenal aortic aneurysms

Endovascular treatment of inflammatory infrarenal aortic aneurysms / Claudio Bianchini Massoni, MD, Philipp von Stein, MD, Melanie Schernthaner, MD, Enrico Gallitto, MD, Fabian Rengier, MD, Barry T. Katzen, MD, Mauro Gargiulo, MD, Dittmar Böckler, MD, and Philipp Geisbüsch, MD

OBJECTIVES: The aim of this study was to evaluate short- and midterm outcomes of endovascular aneurysm repair in patients with inflammatory abdominal aortic aneurysm (IAAA) focusing on changes in perianeurysmal inflammation and hydronephrosis. - METHODS: A retrospective study was performed considering data prospectively gathered from 1998 to 2013 in 3 centers. Patient demographics, preoperative clinical characteristics, clinical presentation, preoperative imaging measurements, procedural, and postoperative data were collected. Main outcome was to define evolution of periaortic fibrosis and hydronephrosis at computed tomography angiography (CTA) during follow-up. - RESULTS: A total of 22 patients (male n = 20; mean age 70.9 years ± 9.3) were included (mean AAA diameter: 58 mm ± 11, symptomatic: 50%, ruptured: 9.1%). Hydroureteronephrosis was preoperatively diagnosed by CTA in 6 (27.3%) cases. Median clinical follow-up was 2.2 years (range 0.1-14.5). Nine patients died during follow-up. At 1, 2, 4, and 6 years, overall survival was 85.4%, 74.3%, 56.6%, and 49.5%, respectively. Among these 13 patients with CTA follow-up, the mean AAA diameter was 56.2 mm ± 15.5, and progression of sac diameter was detected in 1 (7.7%) patient. Median maximum thickness of perianeurysmal inflammation was 5 mm (range 2-11) and decreased/remained unchanged in 92.3% of patients. Regression of hydroureteronephrosis occurred in 3 of 5 patients available for follow-up. There were no cases of de novo hydroureteronephrosis. - CONCLUSION: Endovascular treatment of IAAA has comparable short-term outcomes with non-IAAA. During midterm follow-up, aneurysm sac progression is rare, and perianeurysmal fibrosis decreases or remains unchanged in most cases. Hydronephrosis regression can occur in some but not all instances and thus warrants close surveillance..

Medienart:	E-Artikel

Erscheinungsjahr:	February 10, 2016 2016
Erschienen:	February 10, 2016

Enthalten in:	Zur Gesamtaufnahme - volume:50
Enthalten in:	Vascular and endovascular surgery - 50(2016), 1, Seite 21-28

Sprache:	Englisch

Beteiligte Personen:	Bianchini Massoni, Claudio [VerfasserIn] Stein, Philipp von, 1989- [VerfasserIn] Schernthaner, Melanie [VerfasserIn] Gallitto, Enrico [VerfasserIn] Rengier, Fabian, 1986- [VerfasserIn] Katzen, Barry T. [VerfasserIn] Gargiulo, Mauro [VerfasserIn] Böckler, Dittmar, 1966- [VerfasserIn] Geisbüsch, Philipp, 1978- [VerfasserIn]

Links:	Volltext [lizenzpflichtig]

Themen:	Abdominal aortic aneurysm Aged Aged, 80 and over Aortic Aneurysm, Abdominal Aortography Blood Vessel Prosthesis Implantation Computed Tomography Angiography Disease-Free Survival EVAR Endovascular Procedures Endovascular procedure Female Florida Germany Humans Hydronephrosis Inflammatory perianeurysmal fibrosis Italy Kaplan-Meier Estimate Male Middle Aged Postoperative Complications Retrospective Studies Risk Factors Time Factors Treatment Outcome

Anmerkungen:	Gesehen am 13.05.2020

Umfang:	8

doi:	10.1177/1538574416628652

funding:
Förderinstitution / Projekttitel:

PPN (Katalog-ID):	1698099924

Internformat


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245	1	0	\|a Endovascular treatment of inflammatory infrarenal aortic aneurysms \|c Claudio Bianchini Massoni, MD, Philipp von Stein, MD, Melanie Schernthaner, MD, Enrico Gallitto, MD, Fabian Rengier, MD, Barry T. Katzen, MD, Mauro Gargiulo, MD, Dittmar Böckler, MD, and Philipp Geisbüsch, MD
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520			\|a OBJECTIVES: The aim of this study was to evaluate short- and midterm outcomes of endovascular aneurysm repair in patients with inflammatory abdominal aortic aneurysm (IAAA) focusing on changes in perianeurysmal inflammation and hydronephrosis. - METHODS: A retrospective study was performed considering data prospectively gathered from 1998 to 2013 in 3 centers. Patient demographics, preoperative clinical characteristics, clinical presentation, preoperative imaging measurements, procedural, and postoperative data were collected. Main outcome was to define evolution of periaortic fibrosis and hydronephrosis at computed tomography angiography (CTA) during follow-up. - RESULTS: A total of 22 patients (male n = 20; mean age 70.9 years ± 9.3) were included (mean AAA diameter: 58 mm ± 11, symptomatic: 50%, ruptured: 9.1%). Hydroureteronephrosis was preoperatively diagnosed by CTA in 6 (27.3%) cases. Median clinical follow-up was 2.2 years (range 0.1-14.5). Nine patients died during follow-up. At 1, 2, 4, and 6 years, overall survival was 85.4%, 74.3%, 56.6%, and 49.5%, respectively. Among these 13 patients with CTA follow-up, the mean AAA diameter was 56.2 mm ± 15.5, and progression of sac diameter was detected in 1 (7.7%) patient. Median maximum thickness of perianeurysmal inflammation was 5 mm (range 2-11) and decreased/remained unchanged in 92.3% of patients. Regression of hydroureteronephrosis occurred in 3 of 5 patients available for follow-up. There were no cases of de novo hydroureteronephrosis. - CONCLUSION: Endovascular treatment of IAAA has comparable short-term outcomes with non-IAAA. During midterm follow-up, aneurysm sac progression is rare, and perianeurysmal fibrosis decreases or remains unchanged in most cases. Hydronephrosis regression can occur in some but not all instances and thus warrants close surveillance.
650		4	\|a abdominal aortic aneurysm
650		4	\|a Aged
650		4	\|a Aged, 80 and over
650		4	\|a Aortic Aneurysm, Abdominal
650		4	\|a Aortography
650		4	\|a Blood Vessel Prosthesis Implantation
650		4	\|a Computed Tomography Angiography
650		4	\|a Disease-Free Survival
650		4	\|a endovascular procedure
650		4	\|a Endovascular Procedures
650		4	\|a EVAR
650		4	\|a Female
650		4	\|a Florida
650		4	\|a Germany
650		4	\|a Humans
650		4	\|a hydronephrosis
650		4	\|a inflammatory perianeurysmal fibrosis
650		4	\|a Italy
650		4	\|a Kaplan-Meier Estimate
650		4	\|a Male
650		4	\|a Middle Aged
650		4	\|a Postoperative Complications
650		4	\|a Retrospective Studies
650		4	\|a Risk Factors
650		4	\|a Time Factors
650		4	\|a Treatment Outcome
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Endovascular treatment of inflammatory infrarenal aortic aneurysms / Claudio Bianchini Massoni, MD, Philipp von Stein, MD, Melanie Schernthaner, MD, Enrico Gallitto, MD, Fabian Rengier, MD, Barry T. Katzen, MD, Mauro Gargiulo, MD, Dittmar Böckler, MD, and Philipp Geisbüsch, MD

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