Outcomes of Endovascular Treatment for Infectious Thoracic Aortic Diseases

J Vasc Interv Radiol. 2025 Jan;36(1):139-145. doi: 10.1016/j.jvir.2024.10.012. Epub 2024 Oct 19.

Abstract

Purpose: To investigate the effectiveness and safety of thoracic endovascular aortic repair (TEVAR) for infectious aortic diseases.

Materials and methods: Patients who underwent TEVAR for infectious aortic diseases including infected thoracic aortic aneurysm, aortobronchial fistula (ABF), and aortoenteric fistula from December 2011 to October 2022 at 4 institutions were retrospectively studied. The primary outcome of the study was overall survival, whereas the secondary outcome was comprehensive adverse events. Comprehensive adverse events were defined as a combination of deaths, aortic events, and infectious adverse events.

Results: A total of 28 patients were included in the analysis, with 13 patients having infected thoracic aortic aneurysms, 12 ABFs, and 3 aortoenteric fistulae. Seven patients (25%) underwent additional procedures (abscess drainage, 6 cases; total esophagectomy, 1 case). The mean follow-up period was 30.0 months (SD ± 33.9). The 1-year and 5-year survival rates were 85.7% and 67.9%, respectively. The 1-year and 5-year aorta-related complication-free survival rates were 64.3% and 42.9%, respectively. On univariate analysis, the presence of an ABF was associated with a higher risk of comprehensive adverse events (odds ratio = 11; P = .038).

Conclusions: TEVAR might be a promising treatment for infectious thoracic aortic diseases. Among the infectious pathologies, ABF was considered ominous in terms of late outcomes.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aneurysm, Infected* / diagnostic imaging
  • Aneurysm, Infected* / microbiology
  • Aneurysm, Infected* / mortality
  • Aneurysm, Infected* / surgery
  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / surgery
  • Aortic Aneurysm, Thoracic* / diagnostic imaging
  • Aortic Aneurysm, Thoracic* / mortality
  • Aortic Aneurysm, Thoracic* / surgery
  • Aortic Diseases / diagnostic imaging
  • Aortic Diseases / mortality
  • Aortic Diseases / surgery
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / mortality
  • Bronchial Fistula / diagnostic imaging
  • Bronchial Fistula / etiology
  • Bronchial Fistula / mortality
  • Bronchial Fistula / surgery
  • Endovascular Procedures* / adverse effects
  • Endovascular Procedures* / mortality
  • Female
  • Humans
  • Intestinal Fistula / diagnostic imaging
  • Intestinal Fistula / etiology
  • Intestinal Fistula / mortality
  • Intestinal Fistula / surgery
  • Male
  • Middle Aged
  • Postoperative Complications / mortality
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Vascular Fistula* / diagnostic imaging
  • Vascular Fistula* / mortality
  • Vascular Fistula* / surgery