Endovascular stent-graft placement versus conventional open surgery in infrarenal aortic aneurysm: a prospective study on acute phase response and clinical outcome

Clinica Chimica Acta; International Journal of Clinical Chemistry
E BölkeL Sunder-Plassmann

Abstract

For the treatment of aortic aneurysm, stent-graft implantation is an alternative method to open surgery. There is no study comparing both methods with regard to endotoxaemia, the acute phase cascade, and clinical outcome. In this prospective study, we enrolled 40 patients (34 males, 6 females; mean age 72.1+/-7.5 [58-92] years) with infrarenal abdominal aortic aneurysm who underwent aortic surgery. Comparable groups of patients were treated with open (n=20) or endovascular (n=20) stent-graft implantation. To characterize the inflammatory response, plasma levels of endotoxin, endotoxin-neutralizing capacity (ENC), interleukin-6 (IL-6), C-reactive protein (CRP), and white blood cell count were determined. In all patients, measurements were performed on admission, skin suture, 4 h and from the first to fifth postoperative day. As parameters for the clinical outcome, we assessed daily temperature, lung function, pain, duration of postoperative hospital stay, and morbidity. Wilcoxon rank test was used for statistical analysis. In both groups, a significant increase of endotoxin plasma levels and a decrease of ENC was found already after skin incision. IL-6 levels peaked 4 h postoperatively in both groups, whereas CRP rose at the fir...Continue Reading

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Citations

Oct 28, 2003·Journal of Cardiothoracic and Vascular Anesthesia·Linda M Reilly
Feb 6, 2004·Best Practice & Research. Clinical Anaesthesiology·Ignatius Y Tang, Patrick T Murray
Jan 23, 2016·BioMed Research International·Konstantina KatseniKonstantinos Katsenis
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Aug 25, 2015·Advances in Surgery·Louise de la MotteHenrik Kehlet
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Aug 4, 2004·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·M G A NorwoodR D Sayers
Oct 6, 2006·Current Opinion in Anaesthesiology·Madhav Swaminathan, Mark Stafford-Smith

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