Inflammatory aneurysms of infra-renal abdominal aorta. A case-control study

A case-control study was conducted to identify significant differences in risk factors, clinical presentation, treatment and prognosis between patients with inflammatory aortic aneurysms (group 1) and atherosclerotic abdominal aneurysms (group 2 - controls).

Thirty patients with inflammatory aneurysm were repaired at our institution in a 14-year period and were matched to 60 controls by date of surgery.

Both groups presented similar characteristics concerning age, gender, risk factors to atherosclerosis and ischemic heart disease. Patients with inflammatory aneurysms presented abdominal pain significantly more than controls (80 versus 41.7%; p=0,001). Erythrocyte sedimentation rate was significantly high in group 1 as compared to group 2 (26 versus 5%; p=0,005). The aneurysm size was significantly greater in group 1 (8 versus 6.4 cm; p=0,01). The surgical technique required was similar in both groups, but the aortic clamping time and the mean blood reposition were higher in group 1 (49.5 versus 41 min; p=0,01 and 1508 versus 1034 ml; p=0,013). Intraoperative injury to adjacent organs was significantly greater in group 1 (10 versus 0%; p=0,034). The mortality rate was neither statistically different in the early postoperative setting (10 versus 1.67%) nor in the 5-year survival rate (67 versus 62%; p>0.05) for groups 1 and 2, respectively.

This study showed no differences concerning inflammatory aneurysms in terms of risk factors, treatment required and prognosis. Inflammatory aneurysms tend to present with more symptoms, high erythrocyte sedimentation rate, greater size and retroperitoneal inflammatory reaction than usual aneurysms, making the surgical procedure more difficult.