title: Mid-term clinical outcomes and morphological changes after endovascular aneurysm repair of inflammatory abdominal aortic aneurysms: a single-center experience.
abstract: BACKGROUND
  Endovascular aneurysm repair (EVAR) has been suggested as treatment for inflammatory abdominal aortic aneurysms (IAAA), but the actual clinical and radiological outcomes need to be evaluated.
  
  
  OBJECTIVE
  To report morphological changes in EVAR of IAAAs.
  
  
  METHODS
  Ten male patients (mean age, 67 years; range, 54-78 years) with IAAA were treated with EVAR using endovascular stent-grafts between March 2001 and January 2012. We retrospectively compared computed tomography angiography (CTA) images taken immediately (30 days after the EVAR), short-term (up to 1 year), and mid-term (beyond 1 year) to CTA images taken before the EVAR. Clinical success was defined as successful deployment of the stent-graft without a type I or III endoleak. Morphologic responses of IAAA to EVAR were reviewed by measuring the changes in aneurysm sac maximum diameter (mm), periaortic fibrosis (PAF) thickness (mm), and PAF enhancement (Hounsfield units [HU] on delayed CTA) on serial images.
  
  
  RESULTS
  Ten IAAA patients treated with EVAR were followed for a mean of 42 months (range, 7-129 months). No aneurysm-related deaths were observed during the follow-up of 10 patients. Primary clinical success was achieved in seven patients, assisted primary clinical success in one patient, and secondary clinical success in two patients. Aneurysm sac maximum diameter decreased in all patients (mean percentage reduction of 7.6%, 8.5%, and 17.3% in immediate, short-term, and mid-term follow-up CTA, respectively). PAF thickness decreased in eight patients (10.4%, 16.8%, and 27.2% regression upon follow-up). PAF enhancement decreased in nine patients and increased in one patient (mean percentage decrease of 13.0%, 27.3%, and 40.8% upon follow-up).
  
  
  CONCLUSIONS
  Treatment of IAAA with EVAR was effective and reduced aneurysmal sac diameter and the extent of PAF with acceptable morbidity.
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea jywon@yuhs.ac.
authors.forename: Jong Yun
authors.initials: JY
authors.lastname: Won
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Do Yun
authors.initials: DY
authors.lastname: Lee
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Il Jung
authors.initials: IJ
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Shin Jae
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Man Deuk
authors.initials: MD
authors.lastname: Kim
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Park
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Kwang Hun
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Cardiology Division, Yonsei Cardiovascular Center, Research Institute, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Young Guk
authors.initials: YG
authors.lastname: Ko
authors.affiliation: Cardiology Division, Yonsei Cardiovascular Center, Research Institute, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Dong-Hoon
authors.initials: DH
authors.lastname: Choi
authors.affiliation: Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Eun-Kyung
authors.initials: EK
authors.lastname: Kim
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging* / Q000628:therapy*; D001807:Blood Vessel Prosthesis; D003287:Contrast Media; D057867:Endoleak / Q000000981:diagnostic imaging* / Q000628:therapy; D057510:Endovascular Procedures / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D007479:Iopamidol
keywords: Abdominal aortic aneurysm; CT; endovascular procedures; inflammatory perianeurysmal fibrosis; stents; treatment outcome