Inflammatory Abdominal Aortic Aneurysm (IAAA)

PURPOSE: The aim of this study is to report our experience about the inflammatory abdominal aortic aneurysm (IAAA). METHODS: Between January 1999 and January 2008 we treated 8 cases of IAAA. Two patients underwent surgery in emergency. The preoperative diagnostic procedure were ultrasound (US), computed tomography, (CT) and intravenous urography (IVU). In 6 elective patients the diagnosis of IAAA was obtained preoperatively. In one case a left hydroureteronephrosis was demonstrated by intravenous urography (IVU). All patients underwent open surgery with midline incision and transperitoneal access. RESULTS: No 30-days mortality occurred. A case of pancreatitis was treated with conservative therapy. All patients had 60-days corticosteroid therapy. CONCLUSIONS: Our datas suggest that because IAAA have the same rate of rupture of AAA, they need the same preventive treatment as non inflammatory abdominal aortic aneurysm (AAA). The kind of approach OPEN-EVAR should be chosen with the same criteria as AAA, even if EVAR treatment doesn't allow us to obtain the biopsy. Furthermore there are no sufficient evidences about regression of retroperitoneal fibrosis after EVAR treatment. Also the premature onset should be considered in the choice of treatment.