The present study aimed to analyze the experience of a single center and assess the efficacy and durability of endovascular aortic repair (EVAR) in patients with tuberculous infected native aortic aneurysms (INAAs).
All patients who underwent EVAR for INAAs between September 2014 and August 2021 were retrospectively reviewed. The primary endpoints were 30-day and overall mortality rates; the secondary outcomes included major complications, endoleak, recurrence, re-intervention rate, and thrombosis of the pseudoaneurysmal sac.
A total of 18 patients (average age 61.3 years; 10 female [55.6%]) were identified. Fifteen patients (83.3%) had adjunctive procedures in addition to EVAR. Both the in-hospital and 30-day mortality rates were 0%. The overall cumulative survival rates estimated by Kaplan-Meier were 100% at 1 and 6 months, and 92.3% at 12, 24, and 80.8% at 36 and 48 months. Type Ib and II endoleak each occurred in 1 (5.6%) patient and resolved without treatment after 1 month. No graft infections, strokes, paraplegia, ischemic abdominal complications, or other major complications occurred. The overall rates of cumulative freedom from recurrence of aneurysm and re-intervention were 83.9% and 81.8%, respectively, during the median follow-up period of 28.5 (1-72) months. The median time of administering anti-tuberculosis drugs was 10.5 (2-44) months.
EVAR combined with oral anti-tuberculosis medication is effective and may be an appealing treatment option for high risk INAAs patients. Adjunctive procedures, including targeted drug delivery to the site of infection, could be a solution to further controlling the infection but still needs further evaluation.

Copyright © 2022. Published by Elsevier Inc.