Document Detail


Persistent chronic peri-aortitis ('inflammatory aneurysm') after abdominal aortic aneurysm repair: systematic review of the literature.
MedLine Citation:
PMID:  18940906     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Data on the outcome of aneurysmal chronic peri-aortitis ('inflammatory aneurysm') after open surgical aneurysm repair are few and contradictory. To what extent this inflammatory process is reversed after endovascular aneurysm repair (EVAR) is even more unclear. The objective of this review was to study the outcome of peri-aortic fibrosis (PAF) and ureteral obstruction in patients with aneurysmal chronic peri-aortitis treated with open surgery or EVAR. Medical literature was searched for pertinent articles on the outcome of PAF and ureteral obstruction after open surgery or EVAR from 1970 through October 2007. Studies were included if specific follow-up data were available on outcomes of interest. A total of 19 studies were included comprising 478 patients (open surgical, n = 426; EVAR, n = 52). Age, sex and percentage of patients with ureteral obstruction (31% vs 37%) did not differ between groups. Regression of PAF occurred more frequently after open surgery compared to EVAR (86% vs 60%; p < 0.0001). Complete regression of PAF was more frequent after open surgery compared to EVAR (52% vs 14%; p < 0.0001). After excluding patients in whom concurrent ureterolysis was performed, the frequency of persistent ureteral obstruction remained lower in patients treated surgically compared to patients treated with EVAR, albeit not statistically significant (32% vs 56%; p = 0.09). In conclusion, although open surgery is superior to EVAR in achieving regression of chronic peri-aortitis, the frequency of persistent PAF and/or ureteral obstruction is not negligible. Additional medical and/or urological treatment should be considered in selected cases of aneurysmal chronic peri-aortitis.
Authors:
E F H van Bommel; S J van der Veer; T R Hendriksz; G S Bleumink
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Vascular medicine (London, England)     Volume:  13     ISSN:  1358-863X     ISO Abbreviation:  Vasc Med     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-22     Completed Date:  2009-01-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610930     Medline TA:  Vasc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  293-303     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands. e.f.h.vanbommel@asz.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / complications,  radiography,  surgery*
Aortography / methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation* / adverse effects,  instrumentation
Female
Humans
Immunosuppressive Agents / therapeutic use
Male
Middle Aged
Retroperitoneal Fibrosis / complications,  radiography,  surgery*
Stents
Tomography, X-Ray Computed
Treatment Outcome
Ureteral Obstruction / etiology,  surgery
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents

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