Periaortic Inflammation After Endovascular Aneurysm Repair

Vijaynagar, Badri; McMahon, Greg; McCarthy, Mark J.

doi:10.1016/j.avsg.2010.10.015

Cited by 15 publications

(9 citation statements)

References 13 publications

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“…Mechanisms of local infl ammation may be active when periaortic infl ammation develops around pre-existent aneurysms, which was well documented by serial CTs [66]. Moreover, de-novo periaortitis was observed after stent graft repair of atherosclerotic aortic aneurysms [67,68] which must be considered a possible trigger of infl ammation. Infl ammatory periaortic tissue can be detected in 2-3% of those cases and may even cause ureteral obstruction.…”

Section: Infl Ammatory Abdominal Aneurysm (Iaa)mentioning

confidence: 94%

Inflammatory diseases of the aorta

Caspary

2016

Vasa

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Summary:Infl ammatory aortic diseases may occur with and without dilatation and are complicated by obstruction, rupture and dissection. Infections originate from periaortic foci or septicaemia and tend to result in the rapid development of aneurysms. Large vessel vasculitis due to Takayasu arteritis in younger and giant cell arteritis (GCA) in older patients is located in all layers of the aortic wall and prevails in the thoracic section. GCA patients are prone to developing aortic complications in the late course of disease. In Behçet's disease, aneurysms may have an unusual morphology and localisation. The diagnosis of aortitis is usually obtained by vascular imaging, but partly made only by biopsy on occasion of an operation, especially in case of isolated aortitis of the ascending aorta which mostly remains inapparent until dissection or large aneurysms have developed. Periaortitis typically occurs in the abdominal aorta and may lead to infl ammatory aortic aneurysm (IAA). It is looked upon as a special form of vasculitis, with an overlap to primary retroperitoneal fi brosis (RF). An identical pathology is discussed for the three diseases. On the other hand, about 50 % of isolated aortitides and periaortitides as well as retroperitoneal fi broses can be classed among IgG4-related diseases. Periaortitis also is observed after treatment of aortic aneurysms by stent-graft implantation. Special attention should be paid to ureteral obstruction along with RF or IAA. Once infection is ruled out, immunosuppression is applied to all forms of infl ammatory aortic diseases, primarily with glucocorticoids. However, after successful surgery for isolated thoracic aortitis or infl ammatory aortic aneurysm immunosuppression may be dispensable and it is not required if periaortic tissue enlargement persists in chronic inactive disease. For some patients with periaortitis and RF, tamoxifen may be a valuable alternative.

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Section: Infl Ammatory Abdominal Aneurysm (Iaa)mentioning

confidence: 94%

Inflammatory diseases of the aorta

Caspary

2016

Vasa

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“…We have described an atypical and remote presentation of de novo IAAA that presented 3 years following endovascular repair of a juxta-renal AAA with a fenestrated stent graft. Available case reports/series on the subject have typically described postoperative IAAA within 3 months to 17 months of surgery, usually in association with retroperitoneal fibrosis [6][7][8][9][10][11]. To our knowledge, an IAAA in a setting of a fenestrated aortic stent graft has not been previously been reported.…”

Section: Discussionmentioning

confidence: 92%

Comparative Effectiveness of a Regional Virtual Tumor Board vs. Standard Care for Patients with Hepatocellular Cancer in a Regional Health Network

Salami¹

2017

J Clin Case Rep

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Endovascular aneurysm repair with visceral artery incorporation using fenestrated devices has gained widespread acceptance as a feasible alternative to the traditional open repair for the management of juxta-renal abdominal aortic aneurysms. However, complications with this endovascular technique continue to emerge. We present a patient who developed de novo inflammatory aortic aneurysm 3 years following endovascular repair of a juxta-renal AAA using a fenestrated stent graft.

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“…Five of the eight reported cases of peri-aortitis after EVAR were diagnosed after initially presenting with ureteric obstruction 4, 5, 6, 7, 8, 9, 10, 11. Review of the five cases with ureteric obstruction revealed that one patient required a nephrectomy and two patients underwent ureteric stenting 4 , 5 , 9 . There appears to be no clear consensus regarding the treatment of peri-aortitis secondary to EVAR.…”

Section: Discussionmentioning

confidence: 99%

“…There appears to be no clear consensus regarding the treatment of peri-aortitis secondary to EVAR. Of the eight patients reported previously, five were treated with corticosteroids, one was treated with tamoxifen and two were treated with a combination of corticosteroids and tamoxifen 4, 5, 6, 7, 8, 9, 10, 11. Two of the papers initiated tamoxifen based on the successful treatment of idiopathic retroperitoneal fibrosis by Clarke et al.…”

Section: Discussionmentioning

confidence: 99%

Novel Management of Peri-Aortitis after Endovascular Repair of Abdominal Aortic Aneurysm

Trinder

Mwipatayi

Siew

et al. 2019

EJVES Short Reports

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IntroductionThe management of peri-aortitis, a rare complication after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA), is described in a patient with a solitary kidney.ReportA 64 year old man who developed peri-aortitis after elective EVAR for a 6.6 cm infrarenal AAA is reported. Peri-aortitis was diagnosed two months after the procedure and was successfully treated with corticosteroids.ConclusionThere is no clear consensus on the best medical therapy for peri-aortitis secondary to EVAR. Peri-aortitis must be considered in patients with ongoing systemic symptoms of inflammation after EVAR, and early management is crucial to the early resolution of symptoms.

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Periaortic Inflammation After Endovascular Aneurysm Repair

Cited by 15 publications

References 13 publications

Inflammatory diseases of the aorta

Inflammatory diseases of the aorta

Comparative Effectiveness of a Regional Virtual Tumor Board vs. Standard Care for Patients with Hepatocellular Cancer in a Regional Health Network

Novel Management of Peri-Aortitis after Endovascular Repair of Abdominal Aortic Aneurysm

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