Percutaneous transluminal angioplasty of lower limb arteries causes a systemic inflammatory response.
BACKGROUND
Percutaneous transluminal angioplasty (PTA) of a lower limb arterial segment is a well-established treatment for suitable lesions for critical or noncritical lower limb ischemia. Our aim was to define the inflammatory response after PTA by measuring inflammatory markers.


METHODS
Twenty-five patients having PTA were compared with 20 patients having angiography alone. Interleukin-6 (IL-6), IL-8, IL-10, and tumor necrosis factor-alpha (TNF-alpha) were measured sequentially. The difference between postprocedure and preprocedure baseline levels were compared statistically between angiography alone and PTA. Patients were followed up to 1 year after the procedure, and the failure rate of PTA was noted.


RESULTS
IL-6 and TNF-alpha were significantly higher in PTA patients at 1 hr after PTA (p < 0.05), and the IL-6 level only was significantly higher at 24 hr post-PTA (p < 0.05) compared to angiography alone (Mann-Whitney test). IL-8 and IL-10 levels did not differ significantly in the PTA group. At 1 year after the procedure, 45% of PTAs had failed. There was no statistically significant correlation between failed PTA and inflammatory response.


CONCLUSIONS
PTA appears to cause a significant inflammatory response compared to angiography alone. This demonstrates a systemic manifestation of localized ischemia/reperfusion injury. Further investigation of the inflammatory response due to ischemia/reperfusion injury and its correlation with restenosis is recommended.
Parmar
Jitesh H
JH
Vascular Surgery Department, Hammersmith Hospital, London, UK. jitsparmar@yahoo.co.uk
Aslam
Mo
M
Standfield
Nigel J
NJ
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D001157:Arterial Occlusive Diseases / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007511:Ischemia / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology*; D013997:Time Factors; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D015415:Biomarkers; C508606:CXCL8 protein, human; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10