Ito Eisaku, Toya Naoki, Fukushima Soichiro, Nishie Ryosuke, Akiba Tadashi, Ohki Takao
Division of Vascular Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan.
Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan.
Ann Vasc Dis. 2018 Dec 25;11(4):520-524. doi: 10.3400/avd.oa.18-00058.
: Postimplantation syndrome (PIS) is a postoperative syndrome that occurs after endovascular aneurysm repair (EVAR), accompanied by high fever, leukocytosis, and high serum C-reactive protein (CRP). Its pathogenesis and clinical meaning are still under discussion. Here, we evaluate the relationship between postoperative fever after EVAR and graft fabric focusing on Endologix Powerlink® and AFX® (EPL/AFX). : From January 2015 to July 2017, data on elective EVAR for abdominal aortic aneurysm (AAA) using mainbody were retrospectively collected. The primary endpoint was maximal postoperative fever. : We identified 128 patients who underwent elective EVAR for AAA (105 males, 82%; aged 57-90, median: 74 years). The median maximal postoperative fever was 37.8°C (36.6-39.7°C): polyester graft, 38.2°C (37.1-39.7°C); Excluder®, 37.8°C (36.6-39.2°C); and EPL/AFX, 37.7°C (37-38.7°C). The maximal postoperative fever with a polyester graft was significantly higher than that with an expanded polytetrafluoroethylene (ePTFE) graft (p<0.001). However, there was no difference between Excluder® and EPL/AFX (p=0.214). : In this study, it was found that polyester grafts are significantly associated with PIS after elective EVAR for AAA. If patient anatomy is permitted, it may be better to choose the ePTFE graft, especially for patients with a poor general condition.
植入后综合征（PIS）是一种血管内动脉瘤修复术（EVAR）后出现的术后综合征，伴有高热、白细胞增多和血清C反应蛋白（CRP）升高。其发病机制和临床意义仍在讨论中。在此，我们重点关注Endologix Powerlink®和AFX®（EPL/AFX），评估EVAR术后发热与移植物材料之间的关系。：回顾性收集2015年1月至2017年7月使用主体进行腹主动脉瘤（AAA）择期EVAR的数据。主要终点是术后最高发热温度。：我们确定了128例行AAA择期EVAR的患者（105例男性，82%；年龄57 - 90岁，中位数：74岁）。术后最高发热温度的中位数为37.8°C（36.6 - 39.7°C）：聚酯移植物为38.2°C（37.1 - 39.7°C）；Excluder®为37.8°C（36.6 - 39.2°C）；EPL/AFX为37.7°C（37 - 38.7°C）。聚酯移植物的术后最高发热温度显著高于膨体聚四氟乙烯（ePTFE）移植物（p<0.001）。然而，Excluder®和EPL/AFX之间无差异（p = 0.214）。：在本研究中，发现聚酯移植物与AAA择期EVAR术后的PIS显著相关。如果患者解剖结构允许，选择ePTFE移植物可能更好，特别是对于一般状况较差的患者。
