Tang T, Boyle J R, Dixon A K, Varty K
Regional Vascular Unit, Addenbrooke's NHS Trust, University of Cambridge, Cambridge, UK.
Eur J Vasc Endovasc Surg. 2005 Apr;29(4):353-62. doi: 10.1016/j.ejvs.2004.12.009.
Inflammatory abdominal aortic aneurysms (IAAA) are a variant of aortic aneurysm characterised by extensive peri-aneurysmal fibrosis, thickened walls and dense adhesions and represent between 3 and 10% of all abdominal aortic aneurysms (AAA). Surgery is technically challenging and is still associated with an increased morbidity and mortality. Controversy exists about aetiology and pathogenesis.
We review the literature on the current theories, the available imaging modalities and the current thinking on management of IAAA. A Medline database search was performed. Articles were cross-referenced.
Aneurysm development is multifactorial with important genetic and environmental factors. The literature supports the theory that IAAA arise from the same antigenic stimulus that is responsible for the non-IAAA, representing one extreme of an inflammatory spectrum. The results after open repair have improved and there is now little difference in the mortality between non-IAAA and IAAA repair. However, there is likely to be a role for endovascular stenting in IAAA management and this requires further study. It is clear that closer follow-up of patients after IAAA repair with either technique is necessary to monitor the inflammatory process. No evidence-based follow-up protocol exists but three to six-monthly monitoring of renal function and erythrocyte sedimentation rate (ESR) for 24 months post-repair would seem a reasonable regime.
炎性腹主动脉瘤（IAAA）是腹主动脉瘤的一种变体，其特征为广泛的动脉瘤周围纤维化、增厚的管壁和致密粘连，占所有腹主动脉瘤（AAA）的3%至10%。手术在技术上具有挑战性，且仍与发病率和死亡率增加相关。关于其病因和发病机制存在争议。
我们回顾了有关IAAA当前理论、现有成像方式及当前治疗思路的文献。进行了Medline数据库检索，并对文章进行了交叉引用。
动脉瘤的发生是多因素的，涉及重要的遗传和环境因素。文献支持IAAA与非IAAA源于相同抗原刺激的理论，代表炎症谱的一个极端。开放修复后的结果有所改善，目前非IAAA和IAAA修复后的死亡率差异不大。然而，血管内支架置入术在IAAA治疗中可能有作用，这需要进一步研究。显然，无论采用哪种技术，IAAA修复后对患者进行更密切的随访对于监测炎症过程是必要的。目前尚无基于证据的随访方案，但修复后24个月内每三至六个月监测肾功能和红细胞沉降率（ESR）似乎是合理的方案。
