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Changes in inflammatory response after endovascular treatment for type B aortic dissection
Bernice L Y Cheuk1, Y C Chan, Stephen W K Cheng
1Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Hong Kong Special Administrative Region, China. bernice@hku.hk
Plos One
|June 2, 2012
Summary
Elective endovascular repair for Type B aortic dissection shows minimal inflammatory changes and no significant impact on kidney function. Inflammatory markers like IL-1β and IL-6 temporarily increased but returned to baseline quickly post-procedure.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Inflammation Research
Background:
- Type B aortic dissection with aneurysm poses significant risks.
- Endovascular repair is an evolving treatment modality.
- Understanding the inflammatory response to endovascular aortic repair is crucial.
Purpose of the Study:
- To investigate inflammatory marker changes after elective endovascular repair of Type B aortic dissection.
- To correlate these changes with anatomical features of the dissection flap.
- To assess the impact on renal function.
Main Methods:
- Prospective study of patients undergoing endovascular stent graft repair for Type B aortic dissection.
- Serial monitoring of cytokines (IL-1β, IL-6, IL-8, IL-10, TNF-α), MCP-1, and serum creatinine pre-, peri-, and post-operatively.
- Comparison with a control group receiving conventional medication.
Main Results:
- No 30-day mortality or major post-operative complications (mesenteric ischemia, renal impairment).
- Transient, statistically significant increases in IL-1β and IL-6 post-procedure, returning to baseline within 24 hours.
- No significant changes in serum creatinine levels observed.
- Longer stent graft length showed a trend towards greater IL-1β and IL-6 changes.
Conclusions:
- Elective endovascular repair for Type B aortic dissection is associated with minimal and transient inflammatory mediator changes.
- The procedure demonstrates a less aggressive inflammatory profile compared to open surgery.
- Endovascular aortic repair appears to have an insignificant impact on renal function.
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