Volume of new-onset thrombus is associated with the development of postimplantation syndrome after endovascular aneurysm repair

Abstract

The volume of new-onset thrombus is associated with the development of PIS after EVAR, whereas chronic mural thrombus appears to be an inert material. IMA patency and contrast medium volume are irrelevant to the inflammatory response after EVAR.

Prospective Evaluation of Post-implantation Inflammatory Response After EVAR for AAA: Influence on Patients' 30 Day Outcome

“…3,9 The amount of mural thrombus has also been proposed to incur a role in the inflammatory response, as PIS initially was linked with the release of inflammatory mediators from the aneurysm thrombus. 15,16 Kakisis et al 24 recently evaluated nearly 85 patients after EVAR and reported an association between new onset thrombus and PIS. However, Voûte et al 8 by investigating the relation of PIS with new onset thrombus formation in 136 patients after EVAR did not find any correlation.…”

Postimplantation Syndrome after Endovascular Aneurysm Repair

“…Voûte et al [5] constructed a multivariable risk model for PIS, and woven polyester constitution of the endograft was the only significant factor associated with an increased risk of developing PIS (HR 5.58; p = 0.007). Kakisis et al [18] had similar results when testing for risk factors for PIS using a multivariable model; only the type of endograft was independently associated with the development of PIS.…”

“…In any case, PIS related to Anaconda® endografts had the highest incidence in published literature, except in one study by Nano et al [8] in which the reported incidence was of only 20.3% [4,18,25]. In that study, however, isolated fever without any sign of infection and maintained for more than a week occurred in many patients, even after administration of corticosteroids (median duration, 11 days, (4-30 days)).…”

“…Another retrospective study with 87 patients, using the same definition for PIS, found an incidence of 39%. This value was not similar between graft types, with the highest incidence for Anaconda endograft (71%) and the least incidence in Excluder grafts (13%) [18]. Arnaoutoglou et al [10] prospectively evaluated PIS after elective EVAR in 214 patients with AAAs and investigated its association with clinical outcome during first 30 postoperative days.…”

“…The majority of the studies pointed to a higher incidence of PIS or a greater increase of inflammatory markers in polyester-based endografts [4,5,8,18,20]. Voûte et al [5] constructed a multivariable risk model for PIS, and woven polyester constitution of the endograft was the only significant factor associated with an increased risk of developing PIS (HR 5.58; p = 0.007).…”