Biological responses differ considerably between endovascular and conventional aortic aneurysm surgery

Abstract

Endovascular aortic aneurysm repair induced a significant inflammatory response, mainly involving TNF-alpha and differing from the findings during open AAA repair. These inflammatory responses were probably related to blood pressure decreases during the procedures. On the other hand, conventional repair induced responses related to the more extensive surgical trauma and reperfusion injury.

Changes in thrombin generation, fibrinolysis, platelet and endothelial cell activity, and inflammation following endovascular abdominal aortic aneurysm repair

“…This indicates that the presence of the thrombus in the isolated aneurysm sac does not induce thrombin production as previously suggested. 20,29 The significant increase in TAT at 24 hours postoperatively may be explained by increased binding with antithrombin III in response to manipulation during insertion of the stent graft. Shimazaki et al 18 and Monaco et al 21 showed a significant reduction in antithrombin III and a significant increase in TAT on the first postoperative day.…”

Coagulation, fibrinolysis, and platelet activation in patients undergoing open and endovascular repair of abdominal aortic aneurysm

“…[15][16][17][18] However, some authors have reported that EVAR promotes a systemic inflammatory response and prothrombotic coagulopathy equal if not greater than that witnessed after open surgical repair. 19,20 It has been hypothesized that this is secondary to cytokine release from thrombus within the aneurysm sac either as a result of introducer and catheter manipulation or, possibly, ischemia after AAA exclusion. 19,21 The presence of type II endoleaks may allow these moieties to reach the systemic circulation and cause their deleterious effects.…”

“…19,20 It has been hypothesized that this is secondary to cytokine release from thrombus within the aneurysm sac either as a result of introducer and catheter manipulation or, possibly, ischemia after AAA exclusion. 19,21 The presence of type II endoleaks may allow these moieties to reach the systemic circulation and cause their deleterious effects. The use of contrast media has also been reported to induce arterial endothelial damage, and this may also be relevant to the development of what has been termed "postimplantation syndrome" after EVAR.…”

Aortic Aneurysm Repair Is Associated with a Lower Inflammatory Response Compared with Surgery for Inflammatory Bowel Disease

“…It is known that IL-6 levels have been most commonly found to correlate with the degree of inflammatory insult, including the duration of surgery and the extent of surgical dissection [17,35]. Likewise, IL-8 concentrations have been shown to correlate with the severity of tissue injury and elevations of plasma IL-8 concentrations often appear simultaneously with increases in plasma IL-6 levels [27][28][29].…”