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[Chronic Periaortitis]

Mike Becker1

  • 1Klinik für Rheumatologie, Universitätsspital Zürich.

Therapeutische Umschau. Revue Therapeutique
|May 18, 2022
PubMed

Insights

Chronic periaortitis involves fibroinflammatory diseases affecting the abdominal aorta, potentially causing aneurysm. Diagnosis relies on imaging, with immunosuppressants and interventions like ureteric stents used for treatment, though standardized procedures are lacking.

Area of Science:

  • Vascular Surgery
  • Nephrology
  • Rheumatology

Background:

  • Chronic periaortitis is a group of fibroinflammatory diseases affecting the abdominal aorta.
  • It can be associated with aneurysm formation and previously distinct entities like idiopathic retroperitoneal fibrosis.
  • IgG4-related disease can also be implicated.

Purpose of the Study:

  • To review the diagnosis and treatment of chronic periaortitis.
  • To highlight common complications such as ureteric obstruction and renal failure.

Main Methods:

  • Diagnosis is primarily based on cross-sectional imaging.
  • Therapeutic approaches include immunosuppressive agents, ureteric stenting, and occasionally surgical intervention.

Main Results:

  • Common complications include ureteric obstruction, secondary renal failure, and venous compression with thrombosis.
  • Immunosuppressive agents are frequently used, but robust evidence is limited.
  • Ureteric stenting serves as a bridging therapy.

Conclusions:

  • Standardized treatment protocols for chronic periaortitis are scarce due to disease rarity and heterogeneity.
  • Multidisciplinary management involving imaging, immunosuppression, and interventions is crucial.

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