Tailored Surgical Approaches for Arteritic Aneurysms: A Pictorial Review

Background: Aneurysmal involvement in arteritis is uncommon and presents significant surgical challenges due to vessel wall inflammation, friability, and systemic disease activity. Patients and Methods: A retrospective analysis was performed between November 2023 and November 2025 on 10 patients (mean age: 38.9 years) with arteritis-associated aneurysms, including Takayasu arteritis, rheumatoid arthritis-associated vasculitis, giant cell arteritis, and atypical arteritis. Disease activity was assessed using erythrocyte sedimentation rate and C-reactive protein. Surgical strategy was individualized based on aneurysm characteristics, disease activity, anatomy, and comorbidities. Patients underwent open or endovascular repair following immunosuppressive optimization. Results: Six patients had known arteritis, while four were newly diagnosed. Aneurysms involved the abdominal aorta (60%), iliac (20%), subclavian (10%), and carotid arteries (10%). Open repair was performed in eight patients and endovascular repair in two. Favourable outcomes were achieved in 80%. Thirty-day mortality was 20%, related to perioperative cardiac complications. Conclusion: Disease activity control and individualized surgical planning are critical for successful outcomes in arteritis-associated aneurysms.