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Eur J Cardiothorac Surg 2007;31:406-412. doi:10.1016/j.ejcts.2006.11.053
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Analysis of the inflammatory response in endovascular treatment of aortic aneurysms

Edmo Atique Gabriel*, Rafael Fagionato Locali, Carla Cristina Romano, Alberto José da Silva Duarte, José Honório Palma, Enio Buffolo

Federal University of Sao Paulo – Paulista School of Medicine (Division of Cardiovascular Surgery), Heart Hospital of Sao Paulo (HCOR), Tropical Illnesses Institute of University of Sao Paulo, Brazil

Received 4 August 2006; received in revised form 8 November 2006; accepted 15 November 2006.

* Corresponding author. Address: Napoleao de Barros Street, 715, 3rd floor, Vila Clementino, 04024-002 Sao Paulo-SP, Brazil. Tel.: +55 11 5576 4055; fax: +55 11 5571 2719. (Email: edag{at}uol.com.br).

Objective: The objective of this study is to evaluate the inflammatory response caused by endovascular stents in the treatment of aortic aneurysms. Methods: Twenty-five patients underwent endovascular stent treatment from March through December 2005. The evolution of mediators (sedimentation velocity, C reactive protein, interleukin-6, interleukin-8, tumor necrosis factor-alpha, intercellular adhesion molecule-1, L-selectin), inflammatory cells (leukocytes, lymphocytes, platelets), serum creatinine and body temperature within preoperative period and in the following postoperative periods — 1, 6, 24 and 48 h, 7 days, 1–3 months, was analyzed. In order to achieve statistic significance, Friedman test and Wilcoxon test were used, with index of significance of 5% (p < 0.05). Results: Peak values of sedimentation velocity, C reactive protein and interleukin-6 were observed at 7 days (p < 0.0001), 48 h (p < 0.0001) and 24 h (p < 0.0001), respectively. Tumor necrosis factor-alpha and interleukin-8 did not show statistically significant variability during the entire follow-up. In terms of intercellular adhesion molecule-1 and L-selectin, their expressive values were found in late phase of follow-up, although without statistical significance. Elevation of leukocytes count occurred in premature phase of follow-up (p < 0.0001), while lymphocyte and platelet count occurred in a late phase of follow-up (p < 0.0001). Serum levels of creatinine did not show significant variability during follow-up. The period between 24 and 48 h corresponded to major frequency for fever (p < 0.0001). Conclusion: Individual mediators analysis and inflammatory cells demonstrated variability of their values during postoperative follow-up. This could help in the analysis of the inflammatory response evolution caused by endovascular stent treatment for aortic aneurysms in premature and late phases after implantation of the vascular prosthesis.

Key Words: Aortic aneurysm • Vascular prosthesis • Inflammatory mediators




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Editorial comment: Time course of the inflammatory response after endovascular repair of aortic aneurysms
Eur. J. Cardiothorac. Surg., March 1, 2007; 31(3): 412 - 413.
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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.