Document Detail


The impact of endograft type on inflammatory response after endovascular treatment of abdominal aortic aneurysm.
MedLine Citation:
PMID:  23317524     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the impact of endograft type on the inflammatory response after elective endovascular repair of abdominal aortic aneurysms.
METHODS: From January 2011 to November 2011, we included 100 consecutive patients who underwent elective abdominal aortic aneurysm endovascular repair. Thirteen patients were excluded from the analysis: four with cancer, three with autoimmune disease, two because of recent infection, two who were receiving long-term anti-inflammatory medication, and two because of recent surgery. Temperature, white blood cell count, platelet count, and serum concentrations of cytokines (interleukin [IL]-6, IL-8, and IL-10) were measured preoperatively, 24 hours postoperatively, and 48 hours postoperatively. The study sample was divided into four groups with respect to the type of endograft used: group A, n = 28 (Anaconda; Sulzer Vascutek, Bad Soden, Germany); group B, n = 26 (Zenith; Cook Inc, Bloomington, Ind); group C, n = 23 (Excluder; W. L. Gore and Assoc, Flagstaff, Ariz); and group D, n = 10 (Endurant; Medtronic, Minneapolis, Minn). Endograft configurations included bifurcated grafts only.
RESULTS: Epidemiologic characteristics, atherosclerotic risk factors, type of anesthesia, mean blood loss during surgery, and baseline serum levels of cytokines did not differ among the four groups. Mean elevated temperature was more pronounced postoperatively in group A. Serum levels of IL-6 and IL-10 were significantly higher 24 hours and 48 hours postoperatively compared with preoperative levels in all groups. Patients in group C showed the smallest increase in levels of serum IL-6 and IL-10 at 24 hours and 48 hours postoperatively. Mean difference in cytokine levels after aneurysm exclusion was greater for group A vs group C (P < .01) compared with group A vs B (P < .05). No differences in the mortality and morbidity rates were observed among the four groups.
CONCLUSIONS: Endograft type appears to influence the inflammatory response after endovascular aortic repair. The postimplantation syndrome was apparent during the first 24 hours and decreased afterward. Anaconda and Zenith endografts induced a more intense inflammatory response. A "milder" inflammatory activation was observed in patients with an Excluder endograft. The postimplantation syndrome was not associated with perioperative adverse clinical events showing a benign course. The possible long-term sequelae of postimplantation syndrome require further investigation.
Authors:
Konstantinos G Moulakakis; Maria Alepaki; George S Sfyroeras; Constantine N Antonopoulos; Triantafillos G Giannakopoulos; John Kakisis; Petros Karakitsos; Christos D Liapis
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2013-01-11
Journal Detail:
Title:  Journal of vascular surgery     Volume:  57     ISSN:  1097-6809     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-28     Completed Date:  2013-04-18     Revised Date:  2013-09-19    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  668-77     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Vascular Surgery, University of Athens, Attikon Hospital, Athens, Greece. konmoulakakis@yahoo.gr
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Aortic Aneurysm, Abdominal / mortality,  surgery*
Biological Markers / blood
Blood Vessel Prosthesis*
Blood Vessel Prosthesis Implantation / adverse effects,  instrumentation*,  mortality
Body Temperature Regulation
Chi-Square Distribution
Endovascular Procedures / adverse effects,  instrumentation*,  mortality
Female
Humans
Inflammation / blood,  etiology*,  immunology,  mortality,  physiopathology
Inflammation Mediators / blood
Interleukin-10 / blood
Interleukin-6 / blood
Interleukin-8 / blood
Leukocyte Count
Male
Platelet Count
Prospective Studies
Prosthesis Design
Risk Factors
Stents*
Surgical Procedures, Elective
Time Factors
Treatment Outcome
Up-Regulation
Chemical
Reg. No./Substance:
0/Biological Markers; 0/IL10 protein, human; 0/IL6 protein, human; 0/IL8 protein, human; 0/Inflammation Mediators; 0/Interleukin-6; 0/Interleukin-8; 130068-27-8/Interleukin-10
Comments/Corrections
Comment In:
J Vasc Surg. 2013 Aug;58(2):570   [PMID:  23890450 ]
J Vasc Surg. 2013 Aug;58(2):570-1   [PMID:  23890449 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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