Endovascular therapy of inflammatory aortic aneurysms: a meta-analysis.
OBJECTIVE
To report a meta-analysis of results from endovascular aneurysm repair (EVAR) of inflammatory aortic aneurysms (IAA).


METHODS
A comprehensive literature review was performed to identify all studies reporting the results of EVAR in patients with IAA. To be included in the analysis, an article had to provide a minimum follow-up of 6 months, information about primary technical success, details of immediate and long-term complications, and evaluation of at least one of the basic outcome criteria: changes in aneurysm sac diameter, periaortic fibrosis (PAF), and/ or renal impairment. All studies were reviewed by 2 independent observers for the inclusion criteria. Data were retrieved on the technical and clinical success, outcome criteria, mortality in follow-up, and reinterventions from 14 articles selected from among 701 initially identified.


RESULTS
The 14 articles encompassed 46 patients (45 men [97.8%]; mean age 65 years, range 59-75) with a mean follow-up of 18 months after endovascular repair of IAAs located in the abdominal aorta. The primary technical success rate was 95.6% (44/46) and the 30-day clinical success rate was 93.4% (43/46). The median aneurysm sac diameter regression was 11 mm. Of 43 patients with PAF prior to the intervention, 22 (51.2%) patients showed complete regression, 18 (41.8%) remained unchanged, and 3 (7.0%) showed progression after EVAR. Renal impairment disappeared in 11 (45.8%) of 24 patients. Reinterventions were reported in 8 patients. The procedure-related and follow-up mortality rates were 0% and 13.0%, respectively.


CONCLUSIONS
EVAR of IAA is feasible, excludes the aneurysm effectively, and reduces PAF and renal impairment in most patients with very low periprocedural and midterm mortality and an acceptable reintervention rate.
Puchner
Stefan
S
Department of Angiography and Interventional Radiology, Vienna Medical School, Austria.
Bucek
Robert A
RA
Rand
Thomas
T
Schoder
Maria
M
Hölzenbein
Thomas
T
Kretschmer
Georg
G
Reiter
Markus
M
Lammer
Johannes
J
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001025:Aortitis / Q000000981:diagnostic imaging / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D018450:Disease Progression; D004621:Embolization, Therapeutic; D005121:Extremities / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000628:therapy; D012086:Reoperation; D015607:Stents / Q000009:adverse effects; D015996:Survival Rate; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures