The inflammatory response following treatment of abdominal aortic aneurysms: a comparison between open surgery and endovascular repair.
OBJECTIVE
to compare the inflammatory response following endovascular and conventional AAA repair.


METHODS
prospective study.


METHODS
ten patients were selected for open surgery (OPEN) and ten for endovascular (ENDO) AAA repair. Leukocytes, platelets, myeloperoxidase, lactoferrin, beta-thromboglobulin, C-reactive protein (CRP), interleukin 6 (IL-6), tumour necrosis factor alpha (TNF-alpha) and complement activation products were measured before, during and after surgery.


RESULTS
in the OPEN group the median hospital stay was longer (6 vs. 12 days, p=0.001) and more patients required transfusion (p=0.02). IL-6 and CRP increased postoperatively, most in OPEN (p<0.01). Platelet counts decreased after the first angiography in ENDO (p<0.01) and before aortic cross-clamping in OPEN (p<0.05). The decrease was larger in OPEN (p=0.02). Leukocyte counts decreased after the first angiography in ENDO, and thereafter increased (p=0.001). An equivalent increase was observed in OPEN after declamping (p=0.001). Leukocyte and platelet degranulation products increased after the first angiography in ENDO and after declamping in OPEN. Changes in complement activation products were small. TNF-alpha did not change significantly.


CONCLUSIONS
endovascular AAA repair caused significant leukocyte and platelet activation. Based on the timing of activation this could be caused by radiographic contrast media.
Odegård
A
A
Department of Radiology, Regional Hospital of Trondheim, Norway.
Lundbom
J
J
Myhre
H O
HO
Hatlinghus
S
S
Bergh
K
K
Waage
A
A
Bjerve
K S
KS
Mollnes
T E
TE
Aadahl
P
P
Lie
T A
TA
Videm
V
V
D000210:Acute-Phase Reaction / Q000097:blood / Q000209:etiology* / Q000473:pathology; D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D015415:Biomarkers / Q000097:blood; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D003166:Complement Activating Enzymes / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007813:Laparotomy / Q000009:adverse effects*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000473:pathology; D011379:Prognosis; D011446:Prospective Studies; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014945:Wound Healing
D015415:Biomarkers; D006454:Hemoglobins; D015850:Interleukin-6; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D005340:Fibrinogen; D003166:Complement Activating Enzymes