Sigmoid ischemia and the inflammatory response following endovascular abdominal aortic aneurysm repair

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
N M ElmarasyB R Hopkinson

Abstract

To assess the relationship between sigmoid colonic perfusion, endotoxemia, and cytokine generation in patients undergoing elective open repair (OR) or endovascular repair (EVR) of infrarenal abdominal aortic aneurysms (AAA). Ten patients (9 males; average age 67.6 +/- 2.5 years, mean aneurysm diameter 6.9 +/- 0.6 cm) undergoing OR were compared to 10 patients (all males; average age 70.3 +/- 2.6 years, mean aneurysm diameter 6.5 +/- 0.5 cm) whose repair was performed using the EVR technique. The partial pressure of the carbon dioxide gap (PCO2gap = tissue PCO2 - arterial PCO2) of the sigmoid colonic mucosa was measured using a silicone tonometer to evaluate bowel perfusion. Blood samples were collected into pyrogen-free heparinized tubes for quantification of plasma concentrations of endotoxin, tumor necrosis factor alpha (TNF-alpha), and interleukin 6 (IL-6) before, during, and after aortic repair. Patients in the OR group had a significantly greater increase in PCO2gap, suggesting a greater degree of bowel ischemia compared to the EVR group. This was associated with significantly greater postoperative concentrations of endotoxin, TNF-alpha, and IL-6 in the OR group. A significant correlation was found between PCO2gap, IL-6, a...Continue Reading

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Citations

Jul 6, 2001·European Journal of Radiology·K A HauseggerK Tiesenhausen
Feb 11, 2005·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Gaudencio EspinosaSergio Ricardo Santos
Oct 14, 2000·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·J A MacierewiczB R Hopkinson
Sep 12, 2002·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Robert J HinchliffeBrian R Hopkinson
Jan 28, 2003·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Eric L G VerhoevenReinout van Schilfgaarde
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Jan 23, 2016·BioMed Research International·Konstantina KatseniKonstantinos Katsenis
May 21, 2010·Vascular and Endovascular Surgery·Giorgos S SfyroerasAthanassios D Giannoukas
Mar 1, 2005·The British Journal of Surgery·J GhoshM G Walker

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