Aneurismas inflamatorios de la aorta abdominal
- Estévez, I.
- San Norberto García, Enrique
- Cenizo, Noelia
- Gutiérrez Alonso, Vicente
- Ibáñez, M.A.
- Revilla Calavia, Alvaro
- Merino Díaz, Borja
- Gastambide, María Victoria
- Taylor, J.
- Vaquero Puerta, Carlos
ISSN: 1139-8264
Año de publicación: 2012
Volumen: 15
Número: 1
Páginas: 35-39
Tipo: Artículo
Otras publicaciones en: Revista española de investigaciones quirúrgicas
Resumen
Inflammatory abdominal aortic aneurysms constitute a distinct entity of unknown etiology characterized by a thick wall, a white glistening surface and the presence of inflammatory retroperitoneal scar tissue that traps neighbour structures, especially the ureters. Tipically appear in males and heavy smokers with a mean age of 65 years. They are much more symptomatic than non-inflammatory aneurysms, especially with the presence of abdominal pain, weigth loss and elevated ESR. The gold standard for diagnosis is TAC, with a typical image in four layers (aortic lumen, intraluminal thrombus, calcified and thickened wall and periaortic retroperitoneal mass). Their treatment is based on three pillars: exclusion of the aneurysm (open surgery and EVAR), treatment of fibrosis (corticosteroids and immunosuppressors) and management of complications of the neighbour organs involvement. Open surgery presents major technical challenges with high morbidity and mortality. EVAR appears as an option not only feasible but safe and effective, with similar results to the treatment of non-inflammatory aneurysms with EVAR. The prognosis of these patients depends on the development of retroperitoneal fibrosis, which is highly variable in both open and endovascular surgery. The series we have are still small and short periods of follow up, so it is necessary to follow the long-term evolution of fibrosis post EVAR to reach more definitive conclusions.