Abstract：
BACKGROUND: In Taiwan, infective native aortic aneurysms (INAAs) are relatively common, so the aim of present study was to demonstrate the comparative outcomes of endovascular repair for thoracic and abdominal INAAs.Methods and Results: Patients with naïve thoracic or abdominal INAAs managed with endovascular repair between 2001 and 2018 were included in this multicenter retrospective cohort. The confounding factors were adjusted with propensity score (PS). Of the 39 thoracic and 43 abdominal INAA cases, 41 (50%) presented with aneurysmal rupture, most of which were at the infrarenal abdominal (n=35, 42.7%) or descending thoracic aorta (n=25, 30.5%). Salmonella spp. was the most frequently isolated pathogen. The overall in-hospital mortality rate was 18.3%. The risks of in-hospital death and death due to rupture were significantly lower with thoracic INAAs (12.8% vs. 23.3%; PS-adjusted odds ratio (OR) 0.24, 95% confidence interval (CI) 0.06-0.96; 0.1% vs. 9.3%; PS-adjusted OR 0.11, 95% CI 0.01-0.90). During a mean follow-up of 2.5 years, the risk of all-cause death was significantly higher with thoracic INAAs (35.3% vs. 15.2%; PS-adjusted HR 6.90, 95% CI 1.69-28.19). Chronic kidney disease (CKD) was associated with death.
CONCLUSIONS: Compared with thoracic INAAs, endovascular repair of abdominal INAAs was associated with a significantly higher in-hospital mortality rate. However, long-term outcomes were worse for thoracic INAAs, with CKD and infections being the most important predictor and cause of death, respectively.
CONCLUSIONS: Compared with thoracic INAAs, endovascular repair of abdominal INAAs was associated with a significantly higher in-hospital mortality rate. However, long-term outcomes were worse for thoracic INAAs, with CKD and infections being the most important predictor and cause of death, respectively.
摘要：
背景：在台湾，感染性原生主动脉瘤（INAAs）相对常见，因此,本研究的目的是证明胸腔和腹部INAAs血管内修复术的比较结果.方法和结果：2001年至2018年期间接受腔内修复治疗的初治胸部或腹部INAAs患者被纳入此多中心回顾性队列。混杂因素用倾向评分(PS)进行调整。在39例胸部和43例腹部INAA病例中，41（50%）出现动脉瘤破裂，其中大多数位于肾下腹部（n=35，42.7％）或降胸主动脉（n=25，30.5％）。沙门氏菌属。是最常见的病原体。总体住院死亡率为18.3%。胸部INAA患者住院死亡和破裂死亡的风险显著降低(12.8%vs.23.3%；PS调整后的比值比(OR)0.24，95%置信区间(CI)0.06-0.96；0.1%与9.3%；PS调整OR0.11，95%CI0.01-0.90）。在平均2.5年的随访中，胸部INAAs的全因死亡风险明显更高(35.3%vs.15.2%；PS调整后的HR6.90，95%CI1.69-28.19）。慢性肾脏病（CKD）与死亡相关。
结论：与胸部INAAs相比，腹部INAAs的腔内修复术与院内死亡率显著升高相关.然而,胸部INAAs的长期结果更差，CKD和感染是最重要的预测因素和死亡原因，分别。
结论：与胸部INAAs相比，腹部INAAs的腔内修复术与院内死亡率显著升高相关.然而,胸部INAAs的长期结果更差，CKD和感染是最重要的预测因素和死亡原因，分别。
