Inflammatory abdominal aortic aneurysm endovascular repair into the long-term follow-up

Purpose: To investigate long-term outcomes for inflammatory abdominal aortic aneurysm(IAAA) following endovascular treatment (EVAR).Material and Methods: Between May 1997 and January 2009, 9 male patients (67 yrs, 54– 75) with IAAA were treated with EVAR using commercially available endografts. Resultswere assessed with computed tomography CT at 3 and 12 months, and every subsequenttwo years. Echo-color duplex scanning at 3, 6 and 12 months after discharge and annuallythereafter was also recommended. Primary endpoints were aneurysm-related mortality,aneurysm sac development, peri-aneurysmal fibrosis thickness (PAF) and hydronephrosisevolution.Results: No aneurysm-related deaths were observed during the follow-up of 8 patients (1patient death unknown). Overall mortality rate was 44.4% (4/9) at a mean follow-up of 69.3months (12-140). Maximum aneurysmal sac diameter progressively reduced in 8 patients(89%) and remained unchanged in 1 patient (11%). The absolute mean reduction of theaneurysm size was 26%. PAF regressed in 2 patients (22%), reduced in 5 patients (56%)and remained unchanged in 2 patients (22%). The absolute median reduction of the PAFthickness was 55%. No endoleak was observed during the follow-up period.Hydronephrosis persisted in all 3 patients pre-operatively diagnosed with this pathology.Conclusions: This series suggests that EVAR for IAAA into the long-term is associatedwith a positive trend in both PAF and aneurysm diameter reduction. No association withaneurysm-related mortality was reported. This treatment does not seem to offeradvantages for hydronephrosis.