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Inflammatory abdominal aortic aneurysms.

T Tang1, J R Boyle, A K Dixon

  • 1Regional Vascular Unit, Addenbrooke's NHS Trust, University of Cambridge, Cambridge, UK.

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
|March 8, 2005
PubMed
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Inflammatory abdominal aortic aneurysms (IAAA) are a complex variant of aortic aneurysms. Management strategies are evolving, with improved outcomes for open repair and potential roles for endovascular stenting.

Area of Science:

  • Vascular Surgery
  • Inflammatory Diseases
  • Aortic Aneurysm Research

Background:

  • Inflammatory abdominal aortic aneurysms (IAAA) constitute 3-10% of abdominal aortic aneurysms (AAA).
  • IAAA present unique surgical challenges, associated with higher morbidity and mortality.
  • The etiology and pathogenesis of IAAA remain subjects of ongoing research and debate.

Purpose of the Study:

  • To review current theories on IAAA etiology and pathogenesis.
  • To examine available imaging modalities for IAAA diagnosis and monitoring.
  • To discuss current and emerging management strategies for IAAA.

Main Methods:

  • Comprehensive literature review of Medline database.
  • Cross-referencing of relevant articles.

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  • Synthesis of current knowledge on IAAA.
  • Main Results:

    • Aneurysm development is multifactorial, influenced by genetic and environmental factors.
    • IAAA are proposed to arise from the same antigenic stimulus as non-IAAA, representing an inflammatory spectrum.
    • Open repair outcomes for IAAA have improved, with mortality rates now comparable to non-IAAA repair.

    Conclusions:

    • Endovascular stenting may have a role in IAAA management, warranting further investigation.
    • Close post-repair monitoring for the inflammatory process is crucial for both open and endovascular repairs.
    • A suggested follow-up protocol includes three to six-monthly monitoring of renal function and ESR for 24 months.