Circulating biomarkers are not associated with endoleaks after endovascular repair of abdominal aortic aneurysms

Abstract

Circulating concentrations of MMP9, OPG, D-dimer, HCY, and CRP were not associated with endoleak in patients undergoing EVAR in this study.

Correlation of Baseline Plasma and Inguinal Connective Tissue Metalloproteinases and Their Inhibitors With Late High-Pressure Endoleak After Endovascular Aneurysm Repair: Long-term Results

“…MMPs and their endogenous TIMPs could not be extracted from aneurysmal aortic wall due to the small number of open cases in the study period. However, in contrast to previous studies reporting mean follow-up of 6 to 25 months (only 3 months for plasma MMP-9 assessment), 21,23,24,26 our mean follow-up period exceeded 5 years. Additionally, low-pressure type II endoleaks were excluded from the endoleak group (all sealed within follow-up), thus permitting us to focus on baseline circulating and tissue biomarkers that might be more elevated in patients who developed late endoleaks.…”

“…A large study by Sangiorgi et al 25 also reported higher plasma MMP-9 concentrations in patients with endoleak (40.2±20.9 ng/mL) compared to no-endoleak controls (23.6±10.4 ng/mL). Similar to Moxon et al, 26 circulating concentrations of MMP-9 in patients with endoleak did not exceed those observed in no-endoleak subjects in our study. Evidence suggests that specific markers such as plasma MMP-9 may serve as valuable adjunctive diagnostic tools for detection of endoleak after EVAR, with a sensitivity and specificity of 100% and 96%, respectively, at a cutoff MMP-9 value of 55.18 ng/mL.…”

“…Although only 2 studies correlated high plasma MMP-9 values with the presence of early/midterm endoleak, 21,24 this association was not confirmed in our >5-year study or in the 75-patient study by Moxon et al 26 A consistent thesis across multiple studies is that plasma MMP-9 levels cannot differentiate between different endoleak types, although the form of MMP was not defined exactly. [21][22][23][24][25][26] Our study also determined that only total (pro + active) MMP-9 plasma samples are significantly negatively associated with the presence of hernia at presentation for EVAR. Since there was no correlation between plasma MMP-9 and endoleak, these findings taken together suggest a simultaneous elastin degradation process associated with both aneurysm and hernia at EVAR.…”

“…Evidence suggests that specific markers such as plasma MMP-9 may serve as valuable adjunctive diagnostic tools for detection of endoleak after EVAR, with a sensitivity and specificity of 100% and 96%, respectively, at a cutoff MMP-9 value of 55.18 ng/mL. 21 We had lower plasma values of MMP-9 (15.3±7.7 vs 14±8.1, respectively), but as Moxon and colleagues 26 stated, reasons for this discrepancy may in part be related to population differences, different handling of blood samples, or varying assessment methods. Moreover, the expression of MMP-9 in local aneurysmal walls may not always be systemically reflected in the peripheral blood.…”

The role of osteoprotegerin in the development, progression and management of abdominal aortic aneurysms

“…A leak back into an aneurysm sac is a relatively frequent event in patients with AAA following endovascular repair, and this complication can only be diagnosed by long-term follow-up including regular imaging of the aorta. It is worth noting that Moxon et al diagnosed this type of complication in patients with the largest diameter aneurysms (in 24 of 75 patients) [ 43 ]. The authors analyzed MMP-9 activity and serum concentrations of OPG, d -dimer, homocysteine and C-reactive protein as the possible indicators of leaks in patients with AAA undergoing endovascular aneurysm repair.…”