{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:06:53Z","timestamp":1791288413346,"version":"4.3.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2016,12,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>No reliable comparative data exist between open repair (OR) and endovascular aneurysm repair (EVAR) for mycotic abdominal aortic aneurysms (MAAAs). This nationwide study assessed outcomes after OR and EVAR for MAAA in a population-based cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All patients treated for MAAAs in Sweden between 1994 and 2014 were identified in the Swedish vascular registry. The primary aim was to assess survival after MAAA with OR and EVAR. Secondary aims were analyses of the rate of recurrent infections and reoperations, and time trends in surgical treatment. Survival was analyzed using Kaplan-Meier and log-rank tests. A propensity score\u2013weighted correction for risk factor differences in the 2 groups was performed, including the operation year to account for differences in treatment and outcomes over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We identified 132 patients (0.6% of all operated abdominal aortic aneurysms in Sweden). Mean age was 70 years (standard deviation, 9.2), and 50 presented with rupture. Survival at 3 months was 86% (95% confidence interval, 80%\u201392%), at 1 year 79% (72%\u201386%), and at 5 years 59% (50%\u201368%). The preferred operative technique shifted from OR to EVAR after 2001 (proportion EVAR 1994\u20132000 0%, 2001\u20132007 58%, 2008\u20132014 60%). Open repair was performed in 62 patients (47%): aortic resection and extra-anatomic bypass (n=7), in situ reconstruction (n=50), and patch plasty (n=3); 2 patients died intraoperatively. EVAR was performed in 70 patients (53%): standard EVAR (n=55), fenestrated\/branched EVAR (n=8), and visceral deviation with stent grafting (n=7); no deaths occurred intraoperatively. Survival at 3 months was lower for OR than for EVAR (74% versus 96%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), with a similar trend present at 1 year (73% versus 84%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.054). A propensity score\u2013weighted risk-adjusted analysis confirmed the early better survival associated with EVAR. During median follow-up of 36 and 41 months for OR and EVAR, respectively, there was no difference in long-term survival (5 years 60% versus 58%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.771), infection-related complications (18% versus 24%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.439), or reoperation (21% versus 24%,\n                      <jats:italic>P<\/jats:italic>\n                      =0.650).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study demonstrates a paradigm shift in treatment of MAAA in Sweden, with EVAR being the preferred treatment modality. EVAR was associated with improved short-term survival in comparison with OR, without higher associated incidence of serious infection-related complications or reoperations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.116.024021","type":"journal-article","created":{"date-parts":[[2016,10,31]],"date-time":"2016-10-31T21:11:25Z","timestamp":1477948285000},"page":"1822-1832","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":220,"title":["Nationwide Study of the Treatment of Mycotic Abdominal Aortic Aneurysms Comparing Open and Endovascular Repair"],"prefix":"10.1161","volume":"134","author":[{"given":"Karl","family":"S\u00f6relius","sequence":"first","affiliation":[{"name":"From Department of Surgical Sciences, Section of Vascular Surgery (K.S., A.W., M.B., K.M.), Department of Medical Sciences, Section of Infectious Diseases (M.F.), Uppsala University, Sweden; and Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet, Stockholm, Sweden (P.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Wanhainen","sequence":"additional","affiliation":[{"name":"From Department of Surgical Sciences, Section of Vascular Surgery (K.S., A.W., M.B., K.M.), Department of Medical Sciences, Section of Infectious Diseases (M.F.), Uppsala University, Sweden; and Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet, Stockholm, Sweden (P.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Furebring","sequence":"additional","affiliation":[{"name":"From Department of Surgical Sciences, Section of Vascular Surgery (K.S., A.W., M.B., K.M.), Department of Medical Sciences, Section of Infectious Diseases (M.F.), Uppsala University, Sweden; and Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet, Stockholm, Sweden (P.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Bj\u00f6rck","sequence":"additional","affiliation":[{"name":"From Department of Surgical Sciences, Section of Vascular Surgery (K.S., A.W., M.B., K.M.), Department of Medical Sciences, Section of Infectious Diseases (M.F.), Uppsala University, Sweden; and Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet, Stockholm, Sweden (P.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Gillgren","sequence":"additional","affiliation":[{"name":"From Department of Surgical Sciences, Section of Vascular Surgery (K.S., A.W., M.B., K.M.), Department of Medical Sciences, Section of Infectious Diseases (M.F.), Uppsala University, Sweden; and Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet, Stockholm, Sweden (P.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Mani","sequence":"additional","affiliation":[{"name":"From Department of Surgical Sciences, Section of Vascular Surgery (K.S., A.W., M.B., K.M.), Department of Medical Sciences, Section of Infectious Diseases (M.F.), Uppsala University, Sweden; and Department of Clinical Science and Education, S\u00f6dersjukhuset, Karolinska Institutet, Stockholm, Sweden (P.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Lindstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Karolinska Hospital, Stockholm"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecka","family":"Hultgren","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Karolinska Hospital, Stockholm"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl-Magnus","family":"Wahlgren","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Karolinska Hospital, Stockholm"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5kan","family":"Roos","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Department of Hybrid and Interventional Surgery, Sahlgrenska University Hospital, Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Langenski\u00f6ld","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Department of Hybrid and Interventional Surgery, Sahlgrenska University Hospital, Gothenburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Resch","sequence":"additional","affiliation":[{"name":"Vascular Centre, Sk\u00e5ne University Hospital, Malm\u00f6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Vaccarino","sequence":"additional","affiliation":[{"name":"Vascular Centre, Sk\u00e5ne University Hospital, Malm\u00f6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Bilos","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Vascular Surgery, \u00d6rebro University Hospital, \u00d6rebro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artai","family":"Pirouzram","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery, Faculty of Medicine and Vascular Surgery, \u00d6rebro University Hospital, \u00d6rebro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conny","family":"Arnerl\u00f6v","sequence":"additional","affiliation":[{"name":"Department of Surgical and Perioperative Sciences, Surgery, Ume\u00e5 University Hospital, Ume\u00e5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Simo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Central Hospital Karlstad, Karlstad"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Svensson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Falu Hospital, Falun"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan","family":"Magnusson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Helsingborg Hospital, Helsingborg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00e5kan","family":"Astrand","sequence":"additional","affiliation":[{"name":"Department of Surgery, J\u00f6nk\u00f6ping Hospital, J\u00f6nk\u00f6ping"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils-Peter","family":"Gilgen","sequence":"additional","affiliation":[{"name":"Department of Surgery, M\u00e4lar Hospital, Eskilstuna"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Mellander","sequence":"additional","affiliation":[{"name":"Department of Surgery, NU-Hospitalgroup, Trollh\u00e4ttan\/Uddevalla"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Korman","sequence":"additional","affiliation":[{"name":"Department of Surgery, \u00d6stersunds Hospital, \u00d6stersund"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khatereh","family":"Djavani-Gidlund","sequence":"additional","affiliation":[{"name":"Department of Surgery, G\u00e4vle Hospital, G\u00e4vle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Palm","sequence":"additional","affiliation":[{"name":"Department of Surgery, Sunderby Hospital, Sunderbyn"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e5rten","family":"Huss","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Vascular 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