title: Periaortic inflammation after endovascular aneurysm repair.
abstract: BACKGROUND
  The periaortitis seen with inflammatory abdominal aortic aneurysms usually resolves after repair by both open and endovascular techniques. Conversely, the de novo development of retroperitoneal fibrosis after endovascular aneurysm repair (EVAR) has also been rarely described, and we present a case and also review the literature.
  
  
  RESULTS
  A 63-year-old man underwent EVAR for an asymptomatic, noninflammatory abdominal aortic aneurysm, presenting 9 months subsequently with left loin pain, raised inflammatory markers, and radiological evidence of periaortic inflammation causing significant left ureteric obstruction. Ureteric stenting resolved the hydronephrosis, and the periaortitis improved with combination of steroid and tamoxifen therapy.
  
  
  CONCLUSIONS
  Periaortitis causing renal impairment after EVAR is a rare complication. Prompt recognition and ureteric stenting helps to prevent long-term renal damage. Steroid and tamoxifen therapy is recommended to treat and avoid recurrence of periaortitis.
authors.affiliation: Vascular Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK. badrivv@aol.com
authors.forename: Badri
authors.initials: B
authors.lastname: Vijaynagar
authors.forename: Greg S
authors.initials: GS
authors.lastname: McMahon
authors.forename: Mark J
authors.initials: MJ
authors.lastname: McCarthy
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D057510:Endovascular Procedures / Q000009:adverse effects*; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012185:Retroperitoneal Fibrosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D015607:Stents; D013256:Steroids / Q000627:therapeutic use; D013629:Tamoxifen / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000209:etiology / Q000628:therapy
chemical_list: D000893:Anti-Inflammatory Agents; D013256:Steroids; D013629:Tamoxifen