Systemic inflammatory response to renal artery percutaneous angioplasty with stent placement and the risk for restenosis: a pilot study.
OBJECTIVE
Time changes in plasma concentrations of six different cytokines were investigated to evaluate the inflammatory response to renal artery stent placement.


METHODS
A total of 22 patients (17 men; mean age, 66 years +/- 13) with ostial renal artery stenosis and poorly controlled hypertension treated with stent placement were studied. Blood samples were collected at baseline and at 24 hours and 6 months after the intervention. Plasma concentrations of (i) tumor necrosis factor-alpha, (ii) interleukin-6 (IL-6), (iii) monocyte chemoattractant protein-1, (iv) intercellular adhesion molecule-1, (v) vascular cell adhesion molecule-1, and (vi) regulated upon activatin normal T-cell expressed presumed secreted were measured. Restenosis diagnosed with imaging follow-up at 6 months was recorded. Plasma concentrations of the aforementioned cytokines were compared between patients with and without restenosis.


RESULTS
IL-6 concentration increased significantly 24 hours after stent placement (8.3 pg/mL +/- 1.24 vs. 2.76 pg/mL +/- 1.27 at baseline) and returned to baseline levels (2.6 pg/mL +/- 1.77) at 6-month follow-up (P < .0001). No significant changes occurred in the concentrations of any other cytokines at the three time points. Baseline and 6-month concentrations of IL-6 were significantly higher in patients with restenosis than in those without restenosis (8.13 pg/mL +/- 4 vs 0.75 pg/mL +/- 0.47 [P < .005] and 9.55 pg/mL +/- 6.5 vs 0.42 pg/mL +/- 0.35 [P < .02], respectively).


CONCLUSIONS
Renal artery angioplasty with stent placement induces an inflammatory response, as evidenced by increased IL-6 production. Additionally, IL-6 seems to identify patients prone to develop restenosis; therefore, it might be used as an early predictor of restenosis after renal angioplasty with stent placement. However, larger studies are required to confirm IL-6 as a potential predictor of restenosis.
Brountzos
Elias N
EN
Second Department of Radiology, Athens University Medical School, Attikon University Hospital, Chaidari, Athens, Greece. ebrountz@med.uoa.gr
Tavernaraki
Kyriaki
K
Gouliamos
Athanasios D
AD
Degiannis
Dimitrios
D
Chaidaroglou
Antigoni
A
Panagiotou
Irene
I
Arsenis
George
G
Kelekis
Dimitrios
D
Vlahakos
Demetrios
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D015415:Biomarkers / Q000097:blood; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D016207:Cytokines / Q000097:blood*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology*; D006801:Humans; D007249:Inflammation / Q000209:etiology* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000276:immunology* / Q000601:surgery*; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome
D015415:Biomarkers; D016207:Cytokines