Endovascular repair versus open repair for inflammatory abdominal aortic aneurysms.

BACKGROUND: Inflammatory abdominal aortic aneurysm (IAAA) is a rare but potentially life-threatening condition characterised by marked thickening of the aortic wall, peri-aneurysmal and retroperitoneal fibrosis, and dense adhesions of adjacent abdominal organs. The pathogenesis of IAAA remains an enigma. The main aim of invasive or surgical therapy of AAAs is prevention or correction of aortic rupture. Prevention or treatment of AAA rupture by open or endovascular repair is proven by numerous studies published in the literature. Treatment of IAAA poses a different challenge to surgeons compared with traditional atherosclerotic AAA because of the potential for iatrogenic injury in open repair or, alternatively, potential increased inflammatory response to endoprosthesis implantation.

OBJECTIVES: To assess the effects of elective endovascular versus open repair for inflammatory abdominal aortic aneurysms.

SEARCH METHODS: The Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator (TSC) searched the Specialised Register (April 2015) and the Cochrane Register of Studies (CRS) (2015, Issue 3). The TSC searched trial databases for details of ongoing and unpublished studies.

SELECTION CRITERIA: We sought all published and unpublished randomised controlled trials (RCTs), quasi-RCTs and controlled clinical trials comparing results of elective endovascular or open repair of IAAAs without language restriction.

DATA COLLECTION AND ANALYSIS: Both review authors independently assessed studies identified for potential inclusion in the review. We planned to conduct data collection and analysis in accordance with the Cochrane Handbook for Systematic Review of Interventions.

MAIN RESULTS: We identified no studies that met the inclusion criteria.

AUTHORS' CONCLUSIONS: We found no published RCTs, quasi RCTs or controlled clinical trials comparing open repair and elective endovascular repair for IAAA, assessing immediate (30-day), intermediate (up to one-year follow-up) and long-term (more than one-year follow-up) mortality or complications rates. High-quality studies evaluating the best treatment for inflammatory abdominal aneurysm repair are required.