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

Dang, Quan; Eps, Randolph G. Statius van; Akker, L.H. Van den; Akker, P.J. Van den; Akkersdijk, G. J. M.; Akkersdijk, G.P.; Akkersdijk, W.L.; Kempenaer, M.G. van Andringa de; Arts, C.H.; Avontuur, J. A. M.; Baal, Jeff G. van; Bakker, Olaf J.; Balm, Ron; Barendregt, W.B.; Bender, Mart; Bendermacher, B.L.; Berg, M. van den; Berger, Paul; Beuk, R.J.; Blankensteijn, Jan D.; Bleker, R.J.; Bockel, J.H. van; Bodegom, M.E.; Bogt, Koen E.A. van der; Boll, A.P.M.; Booster, M. H.; Burg, B.L. Borger van der; Borst, Gert J. de; Rossum, W.T. Bos van; Bosma, Jan; Botman, J.M.; Bouwman, Lee H.; Breek, J.C.; Brehm, V.; Brinckman, M.J.; Broek, T.H. van den; Brom, H. L. F.; Bruijn, Martijn; Bruin, Jorg L. de; Brummel, P.; Brussel, J.P. van; Buijk, S.E.; Buimer, M.G.; Burger, D.H.; Buscher, H.C.J.L.; Butter, G. den; Cancrinus, Ernst; Castenmiller, P.H.; Cazander, G.; Coveliers, H.M.E.; Cuypers, P.H.; Daemen, J. H. C.; Dawson, I.; Derom, A.; Dijkema, A.R.; Diks, J.; Dinkelman, M.K.; Dirven, M.; Dolmans, Dennis E. J. G. J.; Doorn, R.C. van; Dortmont, L.M. van; Eb, M.M. van der; Eefting, D.; Eijck, G.J. van; Elshof, Jan-Willem; Elsman, B.H.P.; Elst, A. van der; Engeland, M.I. van; Eps, R.G. van; Faber, M.J.; Fijter, W.M. de; Fioole, Bram; Fritschy, Wilbert M.; Geelkerken, R. H.; Gent, W.B. van; Glade, G.J.; Govaert, Bastiaan; Groenendijk, R.P.R.; Groot, H.G. de; Haak, R.F. van den; Haan, E.F. de; Hajer, G.F.; Hamming, Jaap F.; Hattum, E.S. van; Hazenberg, Constantijn E.V.B.; Joosten, P.P. Hedeman; Helleman, Jozien; Hem, L.G. van der; Hendriks, Johanna M.; Herwaarden, Joost A. van; Heyligers, Jan M.M.; Hinnen, Jan-Willem; Hissink, R.J.; Ho, Gwan H.; Hoed, P.T. den; Hoedt, M.T.C.; Hoek, F. van; Hoencamp, Rigo; Hoffmann, Werner H.; Hoksbergen, Arjan W.J.; Hollander, Edward; Huisman, L.C.; Hulsebos, R.G.; Huntjens, K.M.; Idu, Mirza M.; Jacobs, M.J.; Jagt, M.F. van der; Jansbeken, J.R.; Janssen, Roel; Jiang, H.H.; Jong, S.C. de; Jongkind, Vincent; Kapma, M.R.; Keller, B.P.; Jahrome, A. Khodadade; Kievit, J.K.; Klemm, Peter; Klinkert, P.; Knippenberg, Bob; Koedam, N.A.; Koelemaij, M.J.; Kolkert, J.L.; Koning, G.G.; Koning, Olivier H.J.; Krasznai, A; Krol, R.M.; Kropman, R.H.J.; Kruse, R.R.; Laan, L. van der; Laan, Maarten J. van der; Laanen, J.H. van; Lardenoye, J.H.P.; Lawson, James A.; Legemate, Dink A.; Leijdekkers, V.J.; Lemson, M.S.; Lensvelt, Mare M.A.; Lijkwan, Maarten A.; Lind, Robert; Linden, Fabian; Lung, P.F. Liqui; Loos, Maarten; Loubert, M.C.; Mahmoud, Dalia; Manshanden, C.G.; Mattens, E.C.; Meerwaldt, R.; Mees, Barend; Metz, Roderik; Minnee, Robert C.; Otterloo, J.C. de Mol van; Moll, Frans L.; Swijndregt, Y.C. Montauban van; Morak, Monika; Mortel, R.H. van de; Mulder, W. M. C.; Nagesser, S.K.; Naves, C.C.; Nederhoed, J.H.; Nevenzel-Putters, A.M.; Nie, Anliu; Nieuwenhuis, D.H.; Nieuwenhuizen, J.; Nieuwenhuizen, R.C. van; Nio, D.; Oomen, A.P.; Oranen, B.I.; Oskam, Jacques; Palamba, H.W.; Peppelenbosch, A.G.; Petersen, André S. van; Peterson, T.F.; Petri, Bart‐Jeroen; Pierie, M.E.; Ploeg, Alex; Pol, Robert A.; Ponfoort, E.D.; Poyck, P; Prent, Anna; Raa, Sander Ten; Raymakers, J.T.; Reichart, M.; Reichmann, B.L.; Reijnen, Michel M.P.J.; Rijbroek, A.; Rijn, Marie Josee van; Roo, R.A. de; Rouwet, Ellen V.; Rupert, C.; Saleem, Ben R.; Sambeek, M.R. van; Samyn, M.G.; Sant, H.P. van ’t; Schaik, Jan van; Schaik, P.M. van; Scharn, D.M.; Scheltinga, Marc R.; Schepers, Abbey; Schlejen, P.M.; Schlosser, F.J.; Schol, F.P.; Schouten, Olaf; Schreinemacher, M. H. F.; Schreve, Michiel A; Schurink, G.W.H.; Sikkink, C.J.J.M.; Slaa, Alexander te; Smeets, H.J.; Smeets, Luuk; Smet, A.A. de; Smit, Pieter De Villiers; Smit, P.C.; Smits, T.M.; Snoeijs, Maarten G.; Sondakh, A.O.; Steenhoven, T.J. van der; Sterkenburg, S.M. van; Stigter, D.A.; Stigter, H.; Strating, R.P.; Stultiëns, G.N.; Sybrandy, J.E.; Teijink, Joep A.W.; Telgenkamp, B.J.; Testroote, M.J.; The, R.M.; Thijsse, W.J.; Tielliu, Ignace F.J.; Tongeren, R.B. van; Toorop, Raechel J.; Tordoir, Jan H.M.; Tournoij, E.; Truijers, Maarten; Türkcan, K.; Nolthenius, R.P. Tutein; Ünlü, Çağdaş; Vafi, A.A.; Vahl, A.C.; Veen, Eelco J.; Veger, Hugo T.C.; Veldman, M.G.; Verhagen, H.J.M.; Verhoeven, Bart A.N.; Vermeulen, Christine; Vermeulen, E.G.; Vierhout, B.P.; Visser, M.J.; Vliet, J.A. van der; Keulen, Christine; Voesten, H.G.; Voorhoeve, R.; A, Vos; Vos, B. de; Vos, G.A.; Vriens, B.H.; Vriens, Patrick W.; Vries, A.C. de; Vries, Jean-Paul Pm de; Vries, M. de; Waal, C. van der; Waasdorp, Evert J.; Vries, B.M. Wallis de; Walraven, Laurens A. van; Wanroij, J.L. van; Warlé, Michiel C.; Weel, Chris van; Well, A.M. van; Welten, Gijs M.J.M.; Welten, R.J.Th.J.; Wever, Jan J.; Wiersema, Arno M.; Wikkeling, O.R.; Willaert, W.I.; Wille, Jan; Willems, M.C.; Willigendael, Edith M.; Wisselink, Willem; Witte, M.E.; Wittens, C.H.A.; Jonge, I.C. Wolf-de; Yazar, Ozan; Zeebregts, Clark J.; Zeeland, M.L. van

doi:10.1016/j.jvs.2019.09.060

Cited by 22 publications

(32 citation statements)

References 33 publications

(43 reference statements)

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“…The high rates of previous antibiotic treatment before obtaining blood culture were responsible for the low rate of positive blood culture results in this study. However, the rate of negative cultures in this study was in line with the literature [ 2 , 34 ]. Maximal diameter from the outer border to the outer border of the aneurysm on axial CT image was the standard measurement method in this study.…”

Section: Discussionsupporting

confidence: 92%

Features of infective native aortic aneurysms on computed tomography

et al. 2022

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Background Infective native aortic aneurysm (INAA) is a rare clinical diagnosis. The purpose of this study was to describe the CT findings of INAAs in detail. Methods This was a retrospective single-center study of INAA patients at a major referral hospital between 2005 and 2020. All images were reviewed according to a protocol consisting of aneurysm features, periaortic findings, and associated surrounding structures. Results One hundred and fourteen patients (mean age, 66 years [standard deviation, 11 years]; 91 men) with 132 aneurysms were included. The most common locations were infrarenal (50.8%), aortoiliac (15.2%), and juxtarenal (12.9%). The mean transaxial diameter was 6.2 cm. Most INAAs were saccular (87.9%) and multilobulated (91.7%). Calcified aortic plaque was present in 93.2% and within the aneurysm in 51.5%. INAA instability was classified as contained rupture (27.3%), impending rupture (26.5%), and free rupture (3.8%). Rapid expansion was demonstrated in 13 of 14 (92.9%) aneurysms with sequential CT studies. Periaortic inflammation was demonstrated as periaortic enhancement (94.7%), fat stranding (93.9%), soft-tissue mass (92.4%), and lymphadenopathy (62.1%). Surrounding involvement included psoas muscle (17.8%), spondylitis (11.4%), and perinephric region (2.8%). Twelve patients demonstrated thoracic and abdominal INAA complications: fistulas to the esophagus (20%), bronchus (16%), bowel (1.9%), and inferior vena cava (IVC) (0.9%). Conclusion The most common CT features of INAA were saccular aneurysm, multilobulation, and calcified plaques. The most frequent periaortic findings were enhancement, fat stranding, and soft-tissue mass. Surrounding involvement, including psoas muscle, IVC, gastrointestinal tract, and bronchi, was infrequent but may develop as critical INAA complications.

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Section: Discussionsupporting

confidence: 92%

Features of infective native aortic aneurysms on computed tomography

et al. 2022

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“…Fifty-seven percent of the patients with preoperative blood cultures (96%) had at least one positive blood sample. This is comparable with the 56% found in the nationwide study on thoracic MAAs of Sörelius et al, but higher than the nationwide study of treatment of MAAs in the Netherlands of Dang et al 8,9 Seventy percent of the intraoperative cultures (tissue and/or pus) were positive. From our viewpoint, if open surgery is performed, vascular tissue or pus should be cultured, to maximize the chances of finding the causative micro-organism in order to start targeted antibiotic therapy.…”

Section: Discussionsupporting

confidence: 79%

“…In the literature there are no clear recommendations and durations vary from 4-6 weeks to lifelong. [8][9][10]27 The antibiotic treatment is influenced by the cultured micro-organism, type of surgical repair, and clinical and biochemical status of the patient. 10 Hence treatment of MAA patients should be based individually and discussed in a multidisciplinary team with a vascular surgeon, infectious disease specialist and clinical microbiologist.…”

Section: Discussionmentioning

confidence: 99%

“…The larger abdominal MAA studies are register-based, resulting in less detailed information; they are mainly focused on treatment and do not include conservatively treated patients . 8,9 This retrospective study was conducted to evaluate clinical characteristics, diagnostic approaches, treatment, and outcome of patients with MAA admitted to our tertiary referral center.…”

Section: Introductionmentioning

confidence: 99%

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Patient-Tailored Approach for Diagnostics and Treatment of Mycotic Abdominal Aortic Aneurysm

Liesker¹,

Mulder

Wouthuyzen-Bakker³

et al. 2022

Annals of Vascular Surgery

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“… 19 Another smaller study evaluating open vs endovascular repair for MAAA in the Netherlands found comparable outcomes between the two modalities at 1 year. 20 Selection bias does exist in retrospective studies of SAEF, because patients who underwent endovascular treatment were likely more medically complex and unfit for open repair. Thus, continued debate revolves around whether endovascular management should serve strictly as a bridge to open surgery or if it can be considered a permanent solution.…”

Section: Discussionmentioning

confidence: 99%

Emergent percutaneous chimney endovascular aortic repair of a secondary aortoenteric fistula in the setting of a solitary kidney

Chen

Chaar

Cardella

et al. 2021

Journal of Vascular Surgery Cases, Innovations and Techniques

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Secondary aortoenteric fistula is a potentially lethal complication after aortic surgery. Traditional treatment consists of open graft excision with extra-anatomic bypass or in situ reconstruction. Patients who present in extremis, however, are generally poor candidates for re-do open aortic surgery. Endovascular repair has emerged as an alternative treatment modality for patients who would otherwise be unable to tolerate an extended operation. We report here a case of urgent endovascular repair of a juxtarenal secondary aortoenteric fistula via endovascular aneurysm repair with a renal artery chimney in a patient with a solitary kidney who presented in hemorrhagic and septic shock.

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

Cited by 22 publications

References 33 publications

Features of infective native aortic aneurysms on computed tomography

Features of infective native aortic aneurysms on computed tomography

Patient-Tailored Approach for Diagnostics and Treatment of Mycotic Abdominal Aortic Aneurysm

Emergent percutaneous chimney endovascular aortic repair of a secondary aortoenteric fistula in the setting of a solitary kidney

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