Surgical treatment of inflammatory abdominal aortic aneurysms: Outcome and predictors analysis

The aim of this study is to report our experience on the postoperative outcome of surgical treatment of inflammatory abdominal aortic aneurysm (IAAA).

Between 1997-2014, 35 patients with IAAA underwent surgery. The mean age was 63 ± 18 years. Chronic renal failure was identified in 11 (31.4%) patients and confirmed ischemic heart disease in 15 (43%) patients. The mean aortic aneurysm diameter was 68 ± 25 mm. The abdominal aorta was clamped above the renal arteries in 6 (17%) patients.

The hospital mortality was 5.7% (2 patients). Three patients developed an aortic pseudoaneurysm and underwent a redo operation. Another patient developed a femoral anastomotic pseudoaneurysm 7 years after operation and he was treated surgically. The actuarial free-reoperation actuarial survival at 1, 5 and 7 years was 94%, 62% and 50%, respectively. The Cox model revealed the delta erythrocyte sedimentation rate (p = 0.002), ischemic heart disease (p = 0.006) and renal failure (p = 0.036) as strong predictors for poor overall outcome.

Early postoperative outcome in terms of mortality and morbidity seems acceptable, however, patients with IAAA have an increased risk for reoperation due to pseudonaneurysm formation. Strong predictors for poor overall outcome seem to be the elevated erythrocyte sedimentation rate, ischemic heart disease and chronic renal failure.