Inflammatory Abdominal Aortic Aneurysms

Abstract

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.

Comparative Effectiveness of a Regional Virtual Tumor Board vs. Standard Care for Patients with Hepatocellular Cancer in a Regional Health Network

“…A recent review reported an increased prevalence of Chlamydia, Herpesvirus and Cytomegalovirus in IAAA [14]. Along similar lines, an experimental study demonstrated significant macrophage infiltration in aortic aneurysms following exposure of rabbits to Chlamydia antigens, a finding that was prevented by Azithromycin [15].…”

Abdominal Aortic Aneurysm in a Patient With Low Back Pain

“…16 Computed tomography does have one major disadvantage: it exposes the patient to radiation. 16,38 Magnetic resonance angiography yields similar results to those of computed tomography without exposure to ionizing radiation, but high cost and limited availability have prevented widespread adoption of this modality. 16,38 CONCLUSION A lthough the majority of individuals with AAA are asymptomatic at the time of diagnosis, some patients do present with a history and clinical presentation suggestive of AAA.…”

“…6,22,28 If the presence of an AAA is confirmed with ultrasound imaging, a computed tomography scan is the preferred imaging progression. 16,38 While the sensitivity and specificity of computed tomography imaging of the abdomen are lower than that of ultrasound imaging (sensitivity, 0.79-0.90; specificity, 0.77-0.91), 36 it can detect additional aneurysms, evaluate the surrounding organs, and provide details on arterialwall characteristics (dissection, rupture, or thickening). 16 Computed tomography does have one major disadvantage: it exposes the patient to radiation.…”

IgG4-Related Cardiovascular Disorders

“…73) On the other hand, Tang, et al had a different opinion, suggesting that the thickened inflammatory aneurysmal wall protects itself from rupture risk and corticosteroid therapy may increase rupture risk by weakening the aneurysmal wall. 82) Periaortitis/Periarteritis: Periaortitis and periarteritis are generally classified as inflammatory or infectious conditions. Inflammatory periaortitis and periarteritis include giant cell arteritis, Takayasu arteritis, rheumatoid arthritis, systemic lupus erythematosus (SLE), HLA-B27 associated spondyloarthropathies, ANCA associated vasculitides, Behcet disease, Cogan syndrome, relapsing polychondritis, sarcoidosis, and isolated aortitis such as IgG4-related aortitis or arteritis.…”

“…25,82,106) The therapeutic corticosteroid doses for IgG4-related disease are still unclear. Generally, high-dose corticosteroid therapy is started, tapered over a few months, and then a maintenance dose is administered for several years.…”