Post-implantation syndrome after endovascular repair of aortic aneurysms: need for postdischarge surveillance.

OBJECTIVES

To present the consequences and the need for readmission due to a vigorous inflammatory response in six patients who underwent endovascular repair of aortic aneurysms and developed post-implantation syndrome (PIS), during the postoperative period.

METHODS

From January 2007 to December 2009, 162 patients underwent endovascular repair of an aortic aneurysm. PIS was recorded in 49 patients. Among these, we present six patients who developed a systemic inflammatory response syndrome (SIRS) after discharge from hospital, which led to readmission within the first 30 postoperative days.

RESULTS

Five patients were treated for asymptomatic infrarenal abdominal aortic aneurysm and one for a thoracic one. All patients were discharged from hospital in the absence of any complications, fever or leukocytosis, but several days later they developed features of SIRS leading to readmission, even to the intensive care unit in two of them. After the administration of anti-inflammatory drugs all patients showed a complete recovery and finally left hospital several days later.

CONCLUSIONS

In some patients, the initial inflammatory response following endovascular aortic aneurysm repair is not always spontaneously attenuated and could lead to the development of SIRS even several days after the operation. It seems reasonable that patients developing PIS after endovascular aneurysm repair might be better kept under surveillance for the first postoperative month.