Long-term outcome after inflammatory abdominal aortic aneurysm repair: case-matched study

Area of Science:

• Vascular Surgery
• Gastroenterology
• Immunology

Background:

• Abdominal aortic aneurysms (AAAs) can be inflammatory or noninflammatory, potentially impacting long-term outcomes after surgical repair.
• Graft-related complications and the development of paraanastomotic aneurysms are significant concerns following AAA repair.

Purpose of the Study:

• To compare early and late outcomes of inflammatory AAA repair versus noninflammatory AAA repair.
• To specifically investigate graft-related complications and paraanastomotic aneurysm development in both groups.

Main Methods:

• Retrospective analysis of 625 patients undergoing AAA repair, with 18 classified as inflammatory (group 1) and 54 as noninflammatory (group 2).
• Computer-assisted matching used to control for patient demographics and surgical priority.
• Patients followed with clinical and instrumental examinations, with a focus on long-term graft outcomes.

Main Results:

• Inflammatory AAA patients reported more symptoms and had higher erythrocyte sedimentation rates.
• Surgical morbidity and mortality rates were comparable between groups.
• Ten-year survival rates were similar, but paraanastomotic aneurysm-free survival was significantly lower in the inflammatory AAA group (57.3% vs. 97.8%).
• Higher incidence of graft-related complications observed in the inflammatory AAA group.

Conclusions:

• Inflammatory abdominal aortic aneurysms are associated with a higher risk of developing paraanastomotic aneurysms and other graft-related complications.
• Routine imaging surveillance is crucial for monitoring graft healing after inflammatory AAA repair.
• Inflammatory AAA may be a risk factor for paraanastomotic aneurysm development.