Plasma matrix metalloproteinase 9 levels may predict endoleaks after endovascular aortic aneurysm repair

A simple, noninvasive and cost-effective diagnostic test for the detection of endoleaks after endovascular aneurysm repair (EVAR) would complement (or even replace) current surveillance modalities. We reviewed the literature for studies correlating circulating levels of matrix metalloproteinases (MMPs)/tissue inhibitors of MMPs with the presence of endoleaks after EVAR. An electronic search of databases was performed to identify studies reporting circulating concentrations of MMPs in patients with and without an endoleak after EVAR. Four studies were identified. Patients with an endoleak had higher plasma MMP-9 levels compared with those without an endoleak. Two studies that also evaluated plasma MMP-3 levels after EVAR suggest that these levels may also be higher in patients with an endoleak. Preliminary evidence suggests that MMP-9 levels are increased in patients developing an endoleak after EVAR. Larger studies are required to confirm or refute our findings.