Long-Term Clinical and Radiographic Outcomes in Patients With Clinically Isolated Aortitis.
Long-Term Clinical and Radiographic Outcomes in Patients With Clinically Isolated Aortitis.
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DOI：
10.1002/acr2.11504
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发表时间：
2022-12
影响因子：
3.4
通讯作者：
Rhee, Rennie L.
中科院分区：
文献类型：
--
作者：
Mayer, Adam;Sperry, Alexandra;Quimson, Laarni;Rhee, Rennie L.
动脉瘤修复后偶然发现临床孤立性腹膜炎（CIA）患者的最佳治疗方法尚不清楚。本研究比较了CIA患者和非炎性病因患者胸主动脉瘤手术修复后的长期手术和临床结局。这是一项匹配队列研究。CIA患者通过开放式胸主动脉瘤修复术后的组织病理学确定。根据手术修复的年数，将两种病理学上无炎症的对照药物与每例患者相匹配。结局包括手术并发症、影像学上新的血管异常和死亡。纳入了162例患者：53例CIA患者和109例匹配的对照药物患者。两组的中位随访时间相似（CIA 3.7年vs.对照药物3.3年，P = 0.64）。两组之间在术后并发症、手术翻修或死亡方面没有差异。只有32%的CIA患者在门诊就诊，33%的患者接受免疫抑制治疗。在监测影像学上，CIA患者新发或恶化的主动脉瘤无差异，但胸主动脉分支动脉血管异常明显多于CIA患者（39% vs. 11%，P < 0.01）。在接受胸主动脉瘤手术修复的患者中，CIA患者比非炎症对照者更可能发生主动脉分支动脉的放射学异常。值得注意的是，尽管大多数CIA患者从未接受免疫抑制，但新发主动脉瘤或手术并发症的风险没有差异。这表明，更多的选择性启动免疫抑制在CIA主动脉瘤修复后，可以考虑。
The optimal management of patients with incidentally found clinically isolated aortitis (CIA) after aneurysm repair is unclear. This study compared long‐term surgical and clinical outcomes after surgical repair of thoracic aortic aneurysm between patients with CIA and patients with noninflammatory etiologies. This is a matched cohort study. Patients with CIA were identified by histopathology following open thoracic aortic aneurysm repair. Two comparators without inflammation on pathology were matched to each patient by year of surgical repair. Outcomes included surgical complications, new vascular abnormalities on imaging, and death. One hundred sixty‐two patients were included: 53 with CIA and 109 matched comparators. Median follow‐up time was similar between groups (CIA 3.7 vs. comparator 3.3 years, P = 0.64). There was no difference in postoperative complications, surgical revision, or death between groups. Only 32% of patients with CIA saw a rheumatologist in the outpatient setting and 33% received immunosuppressive treatment. On surveillance imaging, no difference was seen in new or worsening aortic aneurysms, but there were significantly more vascular abnormalities in branch arteries of the thoracic aorta in patients with CIA (39% vs. 11%, P < 0.01). Among patients who underwent surgical repair of a thoracic aortic aneurysm, patients with CIA were more likely than noninflammatory comparators to develop radiographic abnormalities in aortic branch arteries. Notably, there was no difference in risk of new aortic aneurysms or surgical complications despite most patients with CIA never receiving immunosuppression. This suggests that more selective initiation of immunosuppression in CIA may be considered after aortic aneurysm repair.
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影响因子：
4.6
作者：
Zehr, KJ;Mathur, A;Schaff, HV
通讯作者：
Schaff, HV
影响因子：
5.6
作者：
Miller, Dylan V.;Isotalo, Phillip A.;Tazelaar, Henry D.
通讯作者：
Tazelaar, Henry D.
DOI：
10.1016/j.jtcvs.2014.08.003
发表时间：
2015-02-01
影响因子：
6
作者：
Svensson, Lars G.;Arafat, Amr;Lytle, Bruce W.
通讯作者：
Lytle, Bruce W.
影响因子：
4.6
作者：
Prasad, Anjali;Helder, Meghana R. K.;Schaff, Hartzell V.
通讯作者：
Schaff, Hartzell V.
影响因子：
3.9
作者：
Liang, Kimberly P.;Chowdhary, Vaidehi R.;Warrington, Kenneth J.
通讯作者：
Warrington, Kenneth J.