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

Quan Dang; Randolph G Statius van Eps; Jan J Wever; Hugo T C Veger; Dutch Society of Vascular Surgery, the Steering Committee of the Dutch Surgical Aneurysm Audit, and the Dutch Institute for Clinical Auditing

doi:10.1016/j.jvs.2019.09.060

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

J Vasc Surg. 2020 Aug;72(2):531-540. doi: 10.1016/j.jvs.2019.09.060. Epub 2020 Feb 13.

Authors

Quan Dang¹, Randolph G Statius van Eps², Jan J Wever², Hugo T C Veger²; Dutch Society of Vascular Surgery, the Steering Committee of the Dutch Surgical Aneurysm Audit, and the Dutch Institute for Clinical Auditing²

Collaborators

Dutch Society of Vascular Surgery, the Steering Committee of the Dutch Surgical Aneurysm Audit, and the Dutch Institute for Clinical Auditing:
L H Van den Akker, P J Van den Akker, G J Akkersdijk, G P Akkersdijk, W L Akkersdijk, M G van Andringa de Kempenaer, C H Arts, J A Avontuur, J G Baal, O J Bakker, R Balm, W B Barendregt, M H Bender, B L Bendermacher, M van den Berg, P Berger, R J Beuk, J D Blankensteijn, R J Bleker, J H Bockel, M E Bodegom, K E Bogt, A P Boll, M H Booster, B L Borger van der Burg, G J de Borst, W T Bos-van Rossum, J Bosma, J M Botman, L H Bouwman, J C Breek, V Brehm, M J Brinckman, T H van den Broek, H L Brom, M T de Bruijn, J L de Bruin, P Brummel, J P van Brussel, S E Buijk, M G Buimer, D H Burger, H C Buscher, G den Butter, E Cancrinus, P H Castenmiller, G Cazander, H M Coveliers, P H Cuypers, J H Daemen, I Dawson, A F Derom, A R Dijkema, J Diks, M K Dinkelman, M Dirven, D E Dolmans, R C van Doorn, L M van Dortmont, M M van der Eb, D Eefting, G J van Eijck, J W Elshof, B H Elsman, A van der Elst, M I van Engeland, R G van Eps, M J Faber, W M de Fijter, B Fioole, W M Fritschy, R H Geelkerken, W B van Gent, G J Glade, B Govaert, R P Groenendijk, H G de Groot, R F van den Haak, E F de Haan, G F Hajer, J F Hamming, E S van Hattum, C E Hazenberg, P P Hedeman Joosten, J N Helleman, L G van der Hem, J M Hendriks, J A van Herwaarden, J M Heyligers, J W Hinnen, R J Hissink, G H Ho, P T den Hoed, M T Hoedt, F van Hoek, R Hoencamp, W H Hoffmann, A W Hoksbergen, E J Hollander, L C Huisman, R G Hulsebos, K M Huntjens, M M Idu, M J Jacobs, M F van der Jagt, J R Jansbeken, R J Janssen, H H Jiang, S C de Jong, V Jongkind, M R Kapma, B P Keller, A Khodadade Jahrome, J K Kievit, P L Klemm, P Klinkert, B Knippenberg, N A Koedam, M J Koelemaij, J L Kolkert, G G Koning, O H Koning, A G Krasznai, R M Krol, R H Kropman, R R Kruse, L van der Laan, M J van der Laan, J H van Laanen, J H Lardenoye, J A Lawson, D A Legemate, V J Leijdekkers, M S Lemson, M M Lensvelt, M A Lijkwan, R C Lind, F T van der Linden, P F Liqui Lung, M J Loos, M C Loubert, D E Mahmoud, C G Manshanden, E C Mattens, R Meerwaldt, B M Mees, R Metz, R C Minnee, J C de Mol van Otterloo, F L Moll, Y C Montauban van Swijndregt, M J Morak, R H van de Mortel, W Mulder, S K Nagesser, C C Naves, J H Nederhoed, A M Nevenzel-Putters, A J de Nie, D H Nieuwenhuis, J Nieuwenhuizen, R C van Nieuwenhuizen, D Nio, A P Oomen, B I Oranen, J Oskam, H W Palamba, A G Peppelenbosch, A S van Petersen, T F Peterson, B J Petri, M E Pierie, A J Ploeg, R A Pol, E D Ponfoort, P P Poyck, A Prent, S Ten Raa, J T Raymakers, M Reichart, B L Reichmann, M M Reijnen, A Rijbroek, M J van Rijn, R A de Roo, E V Rouwet, C G Rupert, B R Saleem, M R van Sambeek, M G Samyn, H P van 't Sant, J van Schaik, P M van Schaik, D M Scharn, M R Scheltinga, A Schepers, P M Schlejen, F J Schlosser, F P Schol, O Schouten, M H Schreinemacher, M A Schreve, G W Schurink, C J Sikkink, A Te Slaa, H J Smeets, L Smeets, A A de Smet, P de Smit, P C Smit, T M Smits, M G Snoeijs, A O Sondakh, T J van der Steenhoven, S M van Sterkenburg, D A Stigter, H Stigter, R P Strating, G N Stultiëns, J E Sybrandy, J A Teijink, B J Telgenkamp, M J Testroote, R M The, W J Thijsse, I F Tielliu, R B van Tongeren, R J Toorop, J H Tordoir, E Tournoij, M Truijers, K Türkcan, R P Tutein Nolthenius, Ç Ünlü, A A Vafi, A C Vahl, E J Veen, H T Veger, M G Veldman, H J Verhagen, B A Verhoeven, C F Vermeulen, E G Vermeulen, B P Vierhout, M J Visser, J A van der Vliet, C J Vlijmen-van Keulen, H G Voesten, R Voorhoeve, A W Vos, B de Vos, G A Vos, B H Vriens, P W Vriens, A C de Vries, J P de Vries, M de Vries, C van der Waal, E J Waasdorp, B M Wallis de Vries, L A van Walraven, J L van Wanroij, M C Warlé, V van Weel, A M van Well, G M Welten, R J Welten, J J Wever, A M Wiersema, O R Wikkeling, W I Willaert, J Wille, M C Willems, E M Willigendael, W Wisselink, M E Witte, C H Wittens, I C Wolf-de Jonge, O Yazar, C J Zeebregts, M L van Zeeland

Affiliations

¹ Department of Vascular Surgery, Haga Teaching Hospital, The Hague, The Netherlands. Electronic address: michaelqdang@yahoo.com.
² Department of Vascular Surgery, Haga Teaching Hospital, The Hague, The Netherlands.

PMID: 32061482
DOI: 10.1016/j.jvs.2019.09.060

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Abdominal aneurysm; Clinical audit; Endovascular aneurysm repair; Infectious; Mycotic.

Publication types

Comparative Study
Multicenter Study

MeSH terms

Aged
Aneurysm, Infected / diagnostic imaging
Aneurysm, Infected / microbiology
Aneurysm, Infected / mortality
Aneurysm, Infected / surgery*
Anti-Bacterial Agents / administration & dosage
Aortic Aneurysm, Abdominal / diagnostic imaging
Aortic Aneurysm, Abdominal / microbiology
Aortic Aneurysm, Abdominal / mortality
Aortic Aneurysm, Abdominal / surgery*
Blood Vessel Prosthesis Implantation* / adverse effects
Blood Vessel Prosthesis Implantation* / mortality
Drug Administration Schedule
Endovascular Procedures* / adverse effects
Endovascular Procedures* / mortality
Female
Humans
Incidence
Male
Medical Audit
Middle Aged
Netherlands / epidemiology
Patient Readmission
Postoperative Complications / mortality
Postoperative Complications / therapy
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome

Substances

Anti-Bacterial Agents