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Abstract：
OBJECTIVE: This study aimed to determine the therapeutic effectiveness of tuberculous aortic aneurysms (TBAAs) and the risk factors for mortality.
METHODS: We reviewed all case reports of TBAAs treated with open surgery or endovascular aneurysm repair (EVAR) from online database in 1996-2021. Only thoracic and abdominal aortic aneurysms were included.
RESULTS: Eighty cases of open surgery and 42 cases of EVAR were included. The 2-year mortality and perioperative mortality rates of open surgery were 11.3% and 10.0%, respectively. Emergent open surgery had a significantly higher mortality (25.0%) than non-emergent open surgery (6.7%). In the EVAR group, 2-year mortality, perioperative mortality, and TBAA-related mortality were 16.7%, 4.8%, and 10.0%, respectively. Patients with typical tuberculosis (TB) symptoms before EVAR had a significantly higher TBAA-related mortality (35.0%) than patients with no typical TB symptoms before EVAR (0%). In the open surgery group, the rate of TB recurrence (2.7% vs 2.4%) and aneurysm recurrence (8.1% vs 7.3%) were quite close between preoperative anti-TB-treated and postoperative anti-TB-treated cases. However, in the EVAR group, TB recurrence (8.7% vs 0%) and aneurysm recurrence (12.5% vs 6.25%) were more common in postoperative anti-TB-treated cases.
CONCLUSIONS: Open surgery was accompanied by higher perioperative mortality, whereas EVAR was followed with higher TBAA-related mortality. Emergent surgical choices of open surgery may be associated with high perioperative mortality. Typical TB symptoms before EVAR are a significant risk factor for mortality after EVAR. Early anti-TB treatment should be administered if EVAR is the surgical option.
METHODS: We reviewed all case reports of TBAAs treated with open surgery or endovascular aneurysm repair (EVAR) from online database in 1996-2021. Only thoracic and abdominal aortic aneurysms were included.
RESULTS: Eighty cases of open surgery and 42 cases of EVAR were included. The 2-year mortality and perioperative mortality rates of open surgery were 11.3% and 10.0%, respectively. Emergent open surgery had a significantly higher mortality (25.0%) than non-emergent open surgery (6.7%). In the EVAR group, 2-year mortality, perioperative mortality, and TBAA-related mortality were 16.7%, 4.8%, and 10.0%, respectively. Patients with typical tuberculosis (TB) symptoms before EVAR had a significantly higher TBAA-related mortality (35.0%) than patients with no typical TB symptoms before EVAR (0%). In the open surgery group, the rate of TB recurrence (2.7% vs 2.4%) and aneurysm recurrence (8.1% vs 7.3%) were quite close between preoperative anti-TB-treated and postoperative anti-TB-treated cases. However, in the EVAR group, TB recurrence (8.7% vs 0%) and aneurysm recurrence (12.5% vs 6.25%) were more common in postoperative anti-TB-treated cases.
CONCLUSIONS: Open surgery was accompanied by higher perioperative mortality, whereas EVAR was followed with higher TBAA-related mortality. Emergent surgical choices of open surgery may be associated with high perioperative mortality. Typical TB symptoms before EVAR are a significant risk factor for mortality after EVAR. Early anti-TB treatment should be administered if EVAR is the surgical option.
摘要：
目的：本研究旨在确定结核性主动脉瘤（TBAA）的治疗效果以及死亡的危险因素。
方法：我们回顾了1996-2021年在线数据库中所有接受开放手术或血管内动脉瘤修复（EVAR）治疗的TBAA的病例报告。仅包括胸和腹主动脉瘤。
结果：纳入开放手术80例，EVAR42例。开腹手术2年死亡率和围手术期死亡率分别为11.3%和10.0%,分别。紧急开放手术的死亡率（25.0％）明显高于非紧急开放手术（6.7％）。在EVAR组中,2年死亡率，围手术期死亡率，TBAA相关死亡率为16.7%,4.8%，和10.0%，分别。EVAR前有典型结核病（TB）症状的患者的TBAA相关死亡率（35.0％）明显高于EVAR前无典型TB症状的患者（0％）。在开放手术组中，术前抗结核治疗和术后抗结核治疗病例的TB复发率(2.7%vs2.4%)和动脉瘤复发率(8.1%vs7.3%)非常接近.然而,在EVAR组中，在术后抗结核治疗的病例中，结核复发（8.7％vs0％）和动脉瘤复发（12.5％vs6.25％）更为常见。
结论：开腹手术伴随着较高的围手术期死亡率，而EVAR的TBAA相关死亡率较高。开放手术的紧急手术选择可能与高的围手术期死亡率相关。EVAR前的典型TB症状是EVAR后死亡的重要危险因素。如果手术选择EVAR，则应进行早期抗结核治疗。
方法：我们回顾了1996-2021年在线数据库中所有接受开放手术或血管内动脉瘤修复（EVAR）治疗的TBAA的病例报告。仅包括胸和腹主动脉瘤。
结果：纳入开放手术80例，EVAR42例。开腹手术2年死亡率和围手术期死亡率分别为11.3%和10.0%,分别。紧急开放手术的死亡率（25.0％）明显高于非紧急开放手术（6.7％）。在EVAR组中,2年死亡率，围手术期死亡率，TBAA相关死亡率为16.7%,4.8%，和10.0%，分别。EVAR前有典型结核病（TB）症状的患者的TBAA相关死亡率（35.0％）明显高于EVAR前无典型TB症状的患者（0％）。在开放手术组中，术前抗结核治疗和术后抗结核治疗病例的TB复发率(2.7%vs2.4%)和动脉瘤复发率(8.1%vs7.3%)非常接近.然而,在EVAR组中，在术后抗结核治疗的病例中，结核复发（8.7％vs0％）和动脉瘤复发（12.5％vs6.25％）更为常见。
结论：开腹手术伴随着较高的围手术期死亡率，而EVAR的TBAA相关死亡率较高。开放手术的紧急手术选择可能与高的围手术期死亡率相关。EVAR前的典型TB症状是EVAR后死亡的重要危险因素。如果手术选择EVAR，则应进行早期抗结核治疗。
