OBJECTIVE: Perianeurysmal @entity82 (PAF) with involvement of neighbouring viscera can render open repair of inflammatory @entity439 technically difficult and therefore hazardous. For this reason, endovascular repair (EVAR) has been advocated as the preferred approach for this condition. EVAR is known to induce a systemic inflammatory response in @entity1 but the nature of the local response remains unknown. If significant, such a response could exacerbate rather than ameliorate PAF. The aim of the study was to examine the incidence, course and consequences of @entity3807 @entity82 detected by computerised tomography (CT) before and after EVAR. MATERIAL AND METHODS: The clinical records of @entity1 treated by EVAR and followed for at least 6 months were reviewed. Pre and post-operative CT images were independently graded for PAF by three radiologists according to a standard protocol. RESULTS: PAF was documented preoperatively in six out of a total of 61 @entity1 . In two of these PAF worsened after EVAR resulting in @entity1695 and @entity3041 requiring ureteric stents. In the remaining 4 @entity1 PAF did not reduce postoperatively. PAF of low grade developed postoperatively in 10 out of 55 @entity1 (18%) in whom there was no evidence of @entity5567 on preoperative imaging. Median follow-up was 18 months (range 6-36 months). The development of periaortic @entity82 de novopostoperatively was statistically significant (McNemar's test p=0.002). CONCLUSION: EVAR does not seem to reverse PAF if this is present preoperatively and it induces this condition in approximately one sixth of @entity1 without evidence of preoperative PAF. The potential for this adverse inflammatory local response should be taken into account when considering EVAR for treatment of @entity439 with @entity3807 @entity82 and must be weighed against the perceived benefits of this approach.

Perianeurysmal XXXX : a relative contra-indication to endovascular repair.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity82 :: ('MESH:D005355', 'Disease') :: ['fibrosis'] @entity3807 :: ('MESH:D012185', 'Disease') :: ['perianeurysmal'] @entity1695 :: ('MESH:D014517', 'Disease') :: ['ureteric obstruction'] @entity3041 :: ('MESH:D006869', 'Disease') :: ['hydronephrosis'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysms'] @entity5567 :: ('CHEBI:52450', 'Chemical') :: ['PAF']
@entity82 :: (MESH:D005355,Disease) :: ['fibrosis']
