Moulakakis Konstantinos G, Sfyroeras George S, Papapetrou Anastasios, Antonopoulos Constantine N, Mantas George, Kakisis John, Alepaki Maria, Mylonas Spyridon N, Karakitsos Petros, Liapis Christos D
Attikon University Hospital, University of Athens, Greece
Attikon University Hospital, University of Athens, Greece.
J Endovasc Ther. 2015 Apr;22(2):201-6. doi: 10.1177/1526602815573227.
To evaluate inflammatory response and renal function after thoracic endovascular aortic repair (TEVAR) of lesions in the descending thoracic aorta.
Thirty-two consecutive patients treated with TEVAR from January 2010 to August 2013 were enrolled in this prospective study. Two were excluded owing to dissecting thoracic aortic aneurysm (TAA) extending into the renal arteries with renal failure in one and a saccular TAA in which a multilayer flow-modulating stent was implanted in the other. This left 30 patients (28 men; mean age 68.8±5.9 years) with 28 TAAs, an aortic dissection, and an aortic ulcer for the analysis. Temperature and serum levels of white blood cells (WBCs), C-reactive protein (CRP), interleukin-10 (IL-10), IL-6, IL-8, tumor necrosis factor-alpha (TNF-α), creatinine, urea, and cystatin C were measured preoperatively and at 24 and 48 hours postoperatively.
Statistically significant increases in temperature and serum levels of WBCs, CRP, IL-10, and IL-6 were observed 24 and 48 hours postoperatively compared to baseline (all p<0.05). The number of endografts and the coverage of the celiac or subclavian artery did not affect the magnitude of the inflammatory response. No significant differences were observed concerning serum levels of IL-8, TNF-α, creatinine, or cystatin C from baseline to 24 or 48 hours postoperatively.
Endograft implantation in the thoracic aorta may propagate an inflammatory response during the early postoperative period. No clinical adverse events related to the increased inflammatory response were observed. Renal function does not seem to be deteriorated after TEVAR in the descending thoracic aorta.
评估胸降主动脉病变行胸主动脉腔内修复术（TEVAR）后的炎症反应和肾功能。
本前瞻性研究纳入了2010年1月至2013年8月连续接受TEVAR治疗 的32例患者。2例被排除，其中1例因夹层胸主动脉瘤（TAA）延伸至肾动脉并伴有肾衰竭，另1例为囊状TAA且植入了多层血流调节支架。剩余30例患者（28例男性；平均年龄68.8±5.9岁），包括28例TAA、1例主动脉夹层和1例主动脉溃疡用于分析。术前及术后24小时和48小时测量体温、血清白细胞（WBC）、C反应蛋白（CRP）、白细胞介素-10（IL-10）、IL-6、IL-8、肿瘤坏死因子-α（TNF-α）、肌酐、尿素和胱抑素C水平。
与基线相比，术后24小时和48小时体温及血清WBC、CRP、IL-10和IL-6水平有统计学意义的升高（均p<0.05）。腔内移植物数量及腹腔干或锁骨下动脉的覆盖范围不影响炎症反应程度。术后24小时或48小时与基线相比，血清IL-8、TNF-α、肌酐或胱抑素C水平无显著差异。
胸主动脉腔内移植物植入术后早期可能会引发炎症反应。未观察到与炎症反应增加相关的临床不良事件。胸降主动脉TEVAR术后肾功能似乎未恶化。
