Inflammatory mediators after endovascular aortic aneurysm repair

Area of Science:

• Vascular Surgery
• Immunology
• Biomarker Discovery

Background:

• Abdominal aortic aneurysm (AAA) repair aims to prevent rupture.
• Endovascular aortic aneurysm repair (EVAR) is a common AAA treatment.
• Inflammatory processes are implicated in AAA pathogenesis and repair outcomes.

Purpose of the Study:

• To evaluate changes in inflammatory mediators following elective EVAR for AAA.
• To compare these changes with open AAA repair (OR).
• To explore the potential of specific biomarkers in post-EVAR surveillance.

Main Methods:

• Prospective evaluation of 21 patients undergoing elective EVAR for AAA.
• Measurement of soluble urokinase plasminogen activator (suPAR), endothelin (ET)-1, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), CD40 ligand (CD40L), and IgM anti-phosphorylcholine (IgM anti-PC) before and after EVAR.
• Comparison with 5 patients undergoing OR for AAA.

Main Results:

• Post-EVAR, significant increases were observed in suPAR (p<0.001), ET-1 (p=0.003), and IL-6 (p=0.02).
• A significant decrease in IgM anti-PC (p<0.001) was noted after EVAR.
• In patients with unchanged/expanded aneurysm sacs after open repair, suPAR and IL-6 increased; only suPAR increased in those with shrinking sacs. No significant differences were found between EVAR and OR groups for studied markers.

Conclusions:

• The observed plasma biomarker profile suggests ongoing inflammatory activation after EVAR for AAA.
• Interleukin-6 warrants further investigation as a potential plasma biomarker for detecting treatment failure during surveillance after EVAR.
• These findings contribute to understanding the systemic inflammatory response to EVAR.