Abstract
Objectives: Inflammatory abdominal aneurysms (IAAAs) have traditionally been treated using open repair; however, the operative mortality involved is higher than that for atherosclerotic aneurysm repair due to intraoperative technical difficulties associated with periaortic inflammation and dense adhesion to the surrounding organs. Therefore, endovascular repair is a potentially better option for IAAA repair as it does not involve laparotomy and dissection. Methods: We examined 172 patients who underwent endovascular repair for abdominal aortic aneurysms and/or common iliac aneurysms between June 2006 and November 2011. IAAAs were suspected in 9 of these 172 cases (5.2%). Diagnoses were made using patient symptoms and computed tomography (CT) findings. Results: Aneurysm exclusion using stent grafts was performed successfully in all cases. No perioperative deaths or complications were noted. A single case of late death was noted due to advancement of pancreatic cancer. In most cases, significant reduction in aneurysm diameter occurred more quickly following endovascular repair of IAAAs than that noted following atherosclerotic aneurysm repair. No cases converted to open repair in the follow-up period. Although the inflammation persisted and extended to the iliopsoas muscle and vertebral body in 2 cases, it was eventually resolved through conservative treatment. In another case, inflammation recurred 3 years postoperatively around the site of the original inflammatory aneurysm in the common iliac artery; steroid therapy was initiated in this case. Conclusion: Thus, we believe that endovascular repair for IAAAs is a safe and useful option. However, careful follow-up is essential as the long-term results for this treatment and the mechanism of abdominal wall inflammation remain unknown.
