Endovascular treatment of inflammatory infrarenal aortic aneurysms

OBJECTIVES: The aim of this study was to evaluate short- and midterm outcomes of endovascular aneurysm repair in patients with inflammatory abdominal aortic aneurysm (IAAA) focusing on changes in perianeurysmal inflammation and hydronephrosis. - METHODS: A retrospective study was performed consideri...

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Main Authors: Bianchini Massoni, Claudio (Author) , Stein, Philipp von (Author) , Schernthaner, Melanie (Author) , Gallitto, Enrico (Author) , Rengier, Fabian (Author) , Katzen, Barry T. (Author) , Gargiulo, Mauro (Author) , Böckler, Dittmar (Author) , Geisbüsch, Philipp (Author)
Format: Article (Journal)
Language:English
Published: February 10, 2016
In: Vascular and endovascular surgery
Year: 2016, Volume: 50, Issue: 1, Pages: 21-28
ISSN:1938-9116
DOI:10.1177/1538574416628652
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1177/1538574416628652
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Author Notes:Claudio Bianchini Massoni, MD, Philipp von Stein, MD, Melanie Schernthaner, MD, Enrico Gallitto, MD, Fabian Rengier, MD, Barry T. Katzen, MD, Mauro Gargiulo, MD, Dittmar Böckler, MD, and Philipp Geisbüsch, MD

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520 |a OBJECTIVES: The aim of this study was to evaluate short- and midterm outcomes of endovascular aneurysm repair in patients with inflammatory abdominal aortic aneurysm (IAAA) focusing on changes in perianeurysmal inflammation and hydronephrosis. - METHODS: A retrospective study was performed considering data prospectively gathered from 1998 to 2013 in 3 centers. Patient demographics, preoperative clinical characteristics, clinical presentation, preoperative imaging measurements, procedural, and postoperative data were collected. Main outcome was to define evolution of periaortic fibrosis and hydronephrosis at computed tomography angiography (CTA) during follow-up. - RESULTS: A total of 22 patients (male n = 20; mean age 70.9 years ± 9.3) were included (mean AAA diameter: 58 mm ± 11, symptomatic: 50%, ruptured: 9.1%). Hydroureteronephrosis was preoperatively diagnosed by CTA in 6 (27.3%) cases. Median clinical follow-up was 2.2 years (range 0.1-14.5). Nine patients died during follow-up. At 1, 2, 4, and 6 years, overall survival was 85.4%, 74.3%, 56.6%, and 49.5%, respectively. Among these 13 patients with CTA follow-up, the mean AAA diameter was 56.2 mm ± 15.5, and progression of sac diameter was detected in 1 (7.7%) patient. Median maximum thickness of perianeurysmal inflammation was 5 mm (range 2-11) and decreased/remained unchanged in 92.3% of patients. Regression of hydroureteronephrosis occurred in 3 of 5 patients available for follow-up. There were no cases of de novo hydroureteronephrosis. - CONCLUSION: Endovascular treatment of IAAA has comparable short-term outcomes with non-IAAA. During midterm follow-up, aneurysm sac progression is rare, and perianeurysmal fibrosis decreases or remains unchanged in most cases. Hydronephrosis regression can occur in some but not all instances and thus warrants close surveillance. 
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650 4 |a Aged 
650 4 |a Aged, 80 and over 
650 4 |a Aortic Aneurysm, Abdominal 
650 4 |a Aortography 
650 4 |a Blood Vessel Prosthesis Implantation 
650 4 |a Computed Tomography Angiography 
650 4 |a Disease-Free Survival 
650 4 |a endovascular procedure 
650 4 |a Endovascular Procedures 
650 4 |a EVAR 
650 4 |a Female 
650 4 |a Florida 
650 4 |a Germany 
650 4 |a Humans 
650 4 |a hydronephrosis 
650 4 |a inflammatory perianeurysmal fibrosis 
650 4 |a Italy 
650 4 |a Kaplan-Meier Estimate 
650 4 |a Male 
650 4 |a Middle Aged 
650 4 |a Postoperative Complications 
650 4 |a Retrospective Studies 
650 4 |a Risk Factors 
650 4 |a Time Factors 
650 4 |a Treatment Outcome 
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