Inflammatory Aneurysms of the Abdominal Aorta

Open Versus Endovascular Repair of Inflammatory Abdominal Aortic Aneurysms

“…Twenty-two series on OSR for IAAA were identified. 1,8 –28 A statistically significant decline in IAAA incidence was observed in studies published after 1999 (3.1% from 5% in earlier studies, P < .001; Table 3), a finding confirmed on meta-regression analysis (Figure 2). Additionally, operative mortality of OSR was significantly reduced by 59% (from 9.8% to 4%, P = .003, odds ratio: 0.38, 95% CI: 0.20-0.74; Table 3) in studies published after 1999.…”

“…Additionally, this excessive mortality has been attributed to technical problems encountered and intraoperative complications, as a result of the inflammatory changes leading to adhesion of the IAAA with the surrounding structures, including but not limited to the duodenum, the ureters, the left renal, and the iliac veins. 1,11,15 As a result, increased mortality, 13 7.9% in one series compared to 2.4% for ordinary atherosclerotic AAAs, 1 has been reported. Nevertheless, even in contemporary series shown in Table 3, mortality figures amount to 4%, higher than what is achieved nowadays for ordinary atherosclerotic AAAs.…”

Inflammatory Abdominal Aortic Aneurysm Followed by Disseminated Intravascular Coagulation and Immune Thrombocytopenia.

“…The disease is predominantly seen in males and shows a good clinical course. Abdominal pain, elevation of erythrocyte sedimentation rate, and body weight loss are triad of the disease, and CT scan establishes the diagnosis (4,9,12). The IAAAis distinguishable from noncomplicated atherosclerotic aneurysm by the presense of dense perianeurysmal fibrosis and a thickened aortic wall (1-3).…”

“…The incidence of the disease among aortic aneurysms ranges from 2 to 15% (3)(4)(5)(6)(7)(8)(9). Weencountered a patient with IAAAwho had disseminated intravascular coagulation (DIC) and immune thrombocytopenic purpura (ITP).…”

Aortoenteric Fistula: A Late Complication of Endovascular Repair of an Inflammatory Abdominal Aortic Aneurysm

“…2 Characteristics include marked thickening of the aneurysm wall, extensive retroperitoneal and perianeurysmal fibrosis, and dense adhesions to adjacent abdominal organs, including the ureters. 2,3 The most commonly involved adjacent structure is the duodenum, occurring in 79% of patients with inflammatory AAA in 1 series. 2 The etiology of the inflammatory AAA remains controversial.…”