Patient selection: abdominal aortic aneurysm (AAA)
Criteria for an inflammatory abdominal aortic aneurysm - all of the following:
(1) marked thickening of the aneurysm wall
(2) periaortic inflammation and fibrosis that involves adjacent organs
(3) histopathologic evidence of inflammation
Inflammatory abdominal aortic aneurysms comprise from 2-14% of AAA.
Risk factors for long-term mortality:
(1) presence of cardiovascular disease
(2) presence of postoperative chronic renal failure
(3) ongoing fibrosis with entrapment of the ureters
(4) persisting elevation of the erythrocyte sedimentation rate (ESR)
where:
• The hazard ratio for each risk factor is around 2.0, except for the ongoing fibrosis (6.6).
Many patients with an inflammatory abdominal aortic aneurysm can be successfully treated with a low morbidity and mortality. However, a patient with serious cardiovascular disease or ongoing inflammation with fibrosis may require more aggressive management.
