Bajardi Guido, Pecoraro Felice, Mirabella Domenico, Bellisi Mario Girolamo
Cattedra di Chirurgia Vascolare, Università degli Studi di Palermo, Italy.
Ann Ital Chir. 2009 May-Jun;80(3):171-6.
The aim of this study is to report our experience about the inflammatory abdominal aortic aneurysm (IAAA).
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.
No 30-days mortality occurred. A case of pancreatitis was treated with conservative therapy. All patients had 60-days corticosteroid therapy.
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.
本研究旨在报告我们关于炎性腹主动脉瘤（IAAA）的经验。
1999年1月至2008年1月期间，我们治疗了8例IAAA患者。2例患者接受了急诊手术。术前诊断程序包括超声（US）、计算机断层扫描（CT）和静脉肾盂造影（IVU）。在6例择期手术患者中，术前确诊为IAAA。1例患者经静脉肾盂造影（IVU）显示左肾输尿管积水。所有患者均采用中线切口经腹入路进行开放手术。
无30天死亡率。1例胰腺炎患者接受了保守治疗。所有患者均接受了60天的皮质类固醇治疗。
我们的数据表明，由于IAAA与腹主动脉瘤（AAA）具有相同的破裂率，它们需要与非炎性腹主动脉瘤（AAA）相同的预防性治疗。即使腔内修复术（EVAR）治疗无法获取活检组织，选择开放-腔内修复术（OPEN-EVAR）的方法应与AAA相同。此外，关于EVAR治疗后腹膜后纤维化消退，目前尚无充分证据。在选择治疗方法时还应考虑发病过早的情况。
Zotero 插件