Yusuf et al evaluated patients with inflammatory abdominal aortic aneurysms. They identified patients who may benefit from more aggressive management. The authors are from Bezm-I Alem Vakif Gureba Hospital in Instanbul, Turkey.


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)



• 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.


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