title: Arterial Stiffness Alterations and Inflammatory Response Following Endovascular Aortic Repair: Based on a Presentation at the 2013 VEITH Symposium, November 19-23, 2013 (New York, NY, USA).
abstract: Endovascular abdominal aortic aneurysm repair (EVAR) and thoracic aortic aneurysm repair (TEVAR) have been widely incorporated into clinical practice. However, changes in arterial stiffness and post-implantation syndrome after aortic endografting remain important issues under investigation. The aneurysm sac wall motion after successful EVAR and TEVAR reflects complex interactions between all the components of the excluded aneurysm, including true compliance of the aneurysm wall itself, intra-aneurysm sac pressure, remodeling of the thrombus, and mechanical characteristics of the endograft. Experimental and clinical studies have shown that aortic endografting results in increased arterial stiffness in animal models. It can be assumed that the alterations of aortic mechanical properties can have a direct impact on heart output. The long-term impact of these mechanical changes on cardiovascular outcomes and the potential effects of different endografts on hemodynamics are important issues under investigation. Post-implantation syndrome (PIS) is a systemic inflammatory response frequently observed after endovascular treatment of aortic pathologies. The main features of PIS include fever, leukocytosis, elevated C-reactive protein levels, and coagulation disturbances. Endograft design appears to influence this inflammatory response following aortic endografting; woven polyester endografts have been shown to be associated with greater inflammatory response compared to PTFE stent grafts. The purpose of this paper is to review the literature to elucidate arterial stiffness alterations and inflammatory response after EVAR and TEVAR and the impact of endograft design on aortic stiffness and the post-inflammatory response.
authors.affiliation: Department of Vascular Surgery, Medical School, University of Athens, Greece.
authors.forename: Konstantinos G
authors.initials: KG
authors.lastname: Moulakakis
authors.affiliation: Department of Vascular Surgery, Medical School, University of Athens, Greece.
authors.forename: Spyridon N
authors.initials: SN
authors.lastname: Mylonas
authors.affiliation: Department of Vascular Surgery, Medical School, University of Athens, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Kakisis
authors.affiliation: Department of Cardiology, Attikon University Hospital, Athens, Greece.
authors.forename: Nikolaos P E
authors.initials: NP
authors.lastname: Kadoglou
authors.affiliation: Department of Cardiology, Attikon University Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Papadakis
authors.affiliation: Department of Vascular Surgery, Medical School, University of Athens, Greece.
authors.forename: George S
authors.initials: GS
authors.lastname: Sfyroeras
authors.affiliation: Department of Vascular Surgery, Medical School, University of Athens, Greece.
authors.forename: Constantine C N
authors.initials: CC
authors.lastname: Antonopoulos
authors.affiliation: Department of Vascular Surgery, Medical School, University of Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Mantas
authors.affiliation: Department of Cardiology, Attikon University Hospital, Athens, Greece.
authors.forename: Ignatios
authors.initials: I
authors.lastname: Ikonomidis
authors.affiliation: Department of Vascular Surgery, Medical School, University of Athens, Greece.
authors.forename: Christos D
authors.initials: CD
authors.lastname: Liapis
keywords: Aorta; EVAR; Mechanical properties; Post-implantation syndrome; Pulse wave velocity (PWV); Stiffness; TEVAR