The Inflammatory Response to Ruptured Abdominal Aortic Aneurysm Is Altered by Endovascular Repair

Introduction. Ruptured abdominal aortic aneurysm (rAAA) causes a significant inflammatory response. The study aims to investigate this response following endovascular and open repair of ruptured AAA. Patients and Methods. Consecutive rAAA patients had either endovascular aneurysm repair (EVAR) or o...

Full description

Bibliographic Details
Main Authors: Makar, R. R., Badger, S. A., O'Donnell, M. E., Soong, C. V., Lau, L. L., Young, I. S., Hannon, R. J., Lee, B.
Format: Online
Language:English
Published: Hindawi Publishing Corporation 2013
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865732/
id pubmed-3865732
recordtype oai_dc
spelling pubmed-38657322013-12-22 The Inflammatory Response to Ruptured Abdominal Aortic Aneurysm Is Altered by Endovascular Repair Makar, R. R. Badger, S. A. O'Donnell, M. E. Soong, C. V. Lau, L. L. Young, I. S. Hannon, R. J. Lee, B. Clinical Study Introduction. Ruptured abdominal aortic aneurysm (rAAA) causes a significant inflammatory response. The study aims to investigate this response following endovascular and open repair of ruptured AAA. Patients and Methods. Consecutive rAAA patients had either endovascular aneurysm repair (EVAR) or open repair (OR). Blood samples were taken for cytokines, lipid hydroperoxides (LOOH), antioxidants, and neutrophil elastase/α1-anti-trypsin complexes (NE/AAT) before surgery, 6 hours after clamp release and 1, 3, 5 days postoperatively. Results. 30 patients were included in the study, with 14 undergoing eEVAR and 16 eOR, with comparable baseline comorbidities, age, and parameters. IL-6 peaked higher in eOR patients (P = 0.04), while p75TNFr was similar between groups except at day 5 (P = 0.04). The NE/AAT concentrations were higher in eOR patients (P = 0.01), particularly in the first postoperative day, and correlated with blood (r = 0.398, P = 0.029) and platelet (r = 0.424, P = 0.020) volume transfused. C-reactive protein rose and lipid hydroperoxide fell in both groups without significant intergroup difference. Vitamins C and E, lycopene, and β-carotene levels were similar between groups. Conclusion. EVAR is associated with lower systemic inflammatory response compared to OR. Its increased future use may thereby improve outcomes for patients. Hindawi Publishing Corporation 2013 2013-12-02 /pmc/articles/PMC3865732/ /pubmed/24363936 http://dx.doi.org/10.1155/2013/482728 Text en Copyright © 2013 R. R. Makar et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Makar, R. R.
Badger, S. A.
O'Donnell, M. E.
Soong, C. V.
Lau, L. L.
Young, I. S.
Hannon, R. J.
Lee, B.
spellingShingle Makar, R. R.
Badger, S. A.
O'Donnell, M. E.
Soong, C. V.
Lau, L. L.
Young, I. S.
Hannon, R. J.
Lee, B.
The Inflammatory Response to Ruptured Abdominal Aortic Aneurysm Is Altered by Endovascular Repair
author_facet Makar, R. R.
Badger, S. A.
O'Donnell, M. E.
Soong, C. V.
Lau, L. L.
Young, I. S.
Hannon, R. J.
Lee, B.
author_sort Makar, R. R.
title The Inflammatory Response to Ruptured Abdominal Aortic Aneurysm Is Altered by Endovascular Repair
title_short The Inflammatory Response to Ruptured Abdominal Aortic Aneurysm Is Altered by Endovascular Repair
title_full The Inflammatory Response to Ruptured Abdominal Aortic Aneurysm Is Altered by Endovascular Repair
title_fullStr The Inflammatory Response to Ruptured Abdominal Aortic Aneurysm Is Altered by Endovascular Repair
title_full_unstemmed The Inflammatory Response to Ruptured Abdominal Aortic Aneurysm Is Altered by Endovascular Repair
title_sort inflammatory response to ruptured abdominal aortic aneurysm is altered by endovascular repair
description Introduction. Ruptured abdominal aortic aneurysm (rAAA) causes a significant inflammatory response. The study aims to investigate this response following endovascular and open repair of ruptured AAA. Patients and Methods. Consecutive rAAA patients had either endovascular aneurysm repair (EVAR) or open repair (OR). Blood samples were taken for cytokines, lipid hydroperoxides (LOOH), antioxidants, and neutrophil elastase/α1-anti-trypsin complexes (NE/AAT) before surgery, 6 hours after clamp release and 1, 3, 5 days postoperatively. Results. 30 patients were included in the study, with 14 undergoing eEVAR and 16 eOR, with comparable baseline comorbidities, age, and parameters. IL-6 peaked higher in eOR patients (P = 0.04), while p75TNFr was similar between groups except at day 5 (P = 0.04). The NE/AAT concentrations were higher in eOR patients (P = 0.01), particularly in the first postoperative day, and correlated with blood (r = 0.398, P = 0.029) and platelet (r = 0.424, P = 0.020) volume transfused. C-reactive protein rose and lipid hydroperoxide fell in both groups without significant intergroup difference. Vitamins C and E, lycopene, and β-carotene levels were similar between groups. Conclusion. EVAR is associated with lower systemic inflammatory response compared to OR. Its increased future use may thereby improve outcomes for patients.
publisher Hindawi Publishing Corporation
publishDate 2013
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865732/
_version_ 1612039108356472832