P-030 - COMPLETE REMODELING AFTER ENDOVASCULAR AORTIC ANEURYSM REPAIR IN PATIENTS WITH INFECTIVE ABDOMINAL AORTIC ANEURYSM

TOPIC:
Abdominal Aortic Aneurysms
AUTHORS:
Matsuura M. (Kishiwada Tokushukai Hospital ~ Kishiwada ~ Japan) , Kuroyanagi S. (Kishiwada Tokushukai Hospital ~ Kishiwada ~ Japan) , Furuya O. (Kishiwada Tokushukai Hospital ~ Kishiwada ~ Japan) , Higashiue S. (Kishiwada Tokushukai Hospital ~ Kishiwada ~ Japan)
Introduction:
Endovascular aortic aneurysm repair (EVAR) for patients with Infective abdominal aneurysms (IAAA) is still challenging because radical debridement of infected tissue is the gold standard of the treatment. The data of long-term outcomes and radiological analysis after EVAR for these patients are scarce, although some reports stated good short-term results of EVAR. The present study is aimed to examine the effectiveness of EVAR for IAAA.
Methods:
A retrospective review of the surgical database from August 2007 to July 2021 at a single cardiovascular center was performed. We examined the patient's characteristics before surgery and short-term and long-term survival and freedom from reoperation. The rate of complete remodeling was also evaluated.
Results:
A total of 12 cases were identified during this period. Eleven patients were male (92%). The median age was 75 years old (71-80). The maximum diameter was 49mm (41-57mm). Blood culture was positive in 9 cases (75%). BMI is 22(19-23) kg/m², and laboratory results showed Albumin 3.0(2.6-3.1) g/dL, Hb 10.3 (8.8-11.7) g/dL and creatinine 1.1 (0.7-1.6) mg/dL. The 30-day mortality was 17% (2 cases). The 1-year and 3-year survivals were 57% and 48%. Four patients died within one year. The cause of death of these patients was all sepsis. There was no aorta-related death after one year. Reoperations against infection were needed in two cases. One patient required thoracic aortic aneurysm repair with visceral debranching 76 days after the first surgery. Another patient had a thoracoabdominal aorta replacement 98 days after surgery because of the infection's extension to the thoracic aorta. The patients with complete remodeling were identified in 6 cases. All of these patients had a saccular aneurysm. The patient who died because of sepsis also experienced aneurysmal shrinkage.
Conclusion:
The long-term results of endovascular aortic aneurysm repair in patients with the infective aortic aneurysm are acceptable. It can be a definitive treatment. However, some patients need more aggressive surgery against continuing infection.
References:
Karl.Sorelius et al. Eur J vasc Endovasc Surg　2019 Sep;58(3):426-435 Sorelius et al. Circulation. 2016;134:1822-1832
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