Efficacy and Risk Factors of Sac Filling with Rifampin after Endovascular Repair for Treating Brucellosis-Associated Pseudoaneurysms.

BACKGROUND

This study aimed to investigate the efficacy and independent risk factors of sac filling with rifampin after endovascular repair for treating brucellosis-associated pseudoaneurysms.

METHODS

This retrospective study included patients with brucellosis-associated pseudoaneurysms who underwent sac filling with rifampin after endovascular repair. Brucella activity was evaluated using C-reactive protein (CRP) and procalcitonin levels. The patients were followed up for 5 years. Intraoperative and postoperative complications, including paraplegia, endoleak, and stent thrombosis, and mortality were recorded. Kaplan-Meier survival curves were used to estimate the incidence of adverse events, and Cox regression analysis was performed to determine the independent risk factors for adverse events.

RESULTS

A total of 30 patients were included in this study. The procedural success rate was 90%. The mean follow-up period was 51.9 ± 2.8 months. Kaplan-Meier survival analysis revealed that the overall 1-, 3-, and 5-year event-free survival rates were 93%, 80%, and 73%, respectively. Multivariate Cox regression analysis revealed that a preoperative CRP level ≥ 33.65 mg/L and the percentage of neutrophils were independent risk factors for postoperative adverse events. Antibiotic treatment was an independent protective factor.

CONCLUSION

This study showed the efficacy of sac filling with rifampin after endovascular repair in treating brucellosis-associated pseudoaneurysm. CRP level and the percentage of neutrophils are independent risk factors for postoperative adverse events and should be considered before endovascular repair. In addition, antibiotic treatment should be provided to reduce the occurrence of postoperative adverse events.