title: Impact of graft composition on the systemic inflammatory response after an elective repair of an abdominal aortic aneurysm.
abstract: OBJECTIVE
  The present study aimed to evaluate the risk factors and the role of graft material in the development of an acute phase systemic inflammatory response, and the clinical outcome in patients who undergo endovascular aneurysm repair (EVAR) or open surgical repair (OSR) of an abdominal aortic aneurysm (AAA).
  
  
  METHODS
  We retrospectively evaluated the risk factors and the role of graft material in an increased risk of developing systemic inflammatory response syndrome (SIRS), and the clinical outcome in patients who underwent EVAR or OSR of an AAA.
  
  
  RESULTS
  A total of 308 consecutive patients who underwent AAA repair were included; 178 received EVAR and 130 received OSR. There was no significant difference in the incidence of SIRS between EVAR patients and OSR patients. Regardless of treatment modality, SIRS was observed more frequently in patients treated with woven polyester grafts. Postoperative hospitalization was significantly prolonged in patients that experienced SIRS. In multivariate analyses, the initial white blood cell count (P = 0.001) and the use of woven polyester grafts (P = 0.005) were significantly associated with an increased risk of developing SIRS in patients who underwent EVAR. By contrast, the use of woven polyester grafts was the only factor associated with an increased risk of developing SIRS in patients who underwent OSR, although this was not statistically significant (P = 0.052).
  
  
  CONCLUSIONS
  The current study shows that the graft composition plays a primordial role in the development of SIRS, and it leads to prolonged hospitalization in both EVAR and OSR patients.
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Jong Kwan
authors.initials: JK
authors.lastname: Baek
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Hyunwook
authors.initials: H
authors.lastname: Kwon
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Ko
authors.affiliation: Biostatistics Collaboration Unit, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Min Joo
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Youngjin
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Surgery, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea.
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Chung
authors.affiliation: Department of Surgery, Ulsan University Hospital, Ulsan, Korea.
authors.forename: Hojong
authors.initials: H
authors.lastname: Park
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Tae-Won
authors.initials: TW
authors.lastname: Kwon
authors.affiliation: Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Yong-Pil
authors.initials: YP
authors.lastname: Cho
keywords: Aneurysm; Aorta; Composition; Graft; Inflammatory response