炎性腹主动脉瘤诊断及治疗

Diagnosis and treatment progression of inflammatory abdominal aortic aneurysms

炎性腹主动脉瘤（inflammatoryabdominalaorticaneurysms，iAAA）是腹主动脉瘤的一种特殊类型，占腹主动脉瘤的2％～10％，其病因、发病机制仍然不清，病理特征为瘤壁增厚、瘤周广泛纤维化、腹腔内粘连。CT能可靠显示主动脉周围环状炎性物质，已逐渐变成诊断iAAA的主流方法。腹腔广泛的炎性纤维化使外科手术治疗iAAA存在较大风险，但血管腔内治疗使动脉瘤周围炎症改善，特别适合外科手术失败者。目前，血管腔内修复已被推荐为iAAA一线治疗方法。

Inflammatory abdominal aortic aneurysms （iAAA）are a variant of aortic anesm characterized by extensive peri-aneurysmal fibrosis, thickened walls and dense adhesions and represent between 2% and 10% of all abdominal aortic aneurysms （AAA）. The etiology of iAAA is understood poorly. Aneurysm development is multifactorial with important genetic and environmental factors. Computed tomography （CT）has become the mainstay of assessing iAAA. The perioperative mortality associated with open iAAA repair is increased compared with normal AAAs, largely due to intraoperative technical difficulties related to inflammation. Endovascular repair （EVAR） for iAAA results in successful management with improvement of periaortic inflammation. It is particularly useful when open repair has failed. EVAR should be considered as first-line therapy in which anatomic parameters are favorable.