Inflammatory mediators after endovascular aortic aneurysm repair

- SuPAR, IL-6 and ET-1 increased and IgM anti-PC decreased after elective EVAR.
- Our results indicate on-going inflammatory activation in AAA patients after EVAR.
- The level of IL-6 was associated with aneurysm sac size after EVAR.

ObjectiveTo evaluate patterns of inflammatory mediators before and after elective endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA).Materials and methodsInflammatory mediators including soluble urokinase plasminogen activator (suPAR), endothelin (ET)-1, tumour necrosis factor (TNF)-α, interleukin (IL)-6, CD40 ligand (CD40L) and IgM antibodies against phosphorylcholine (IgM anti-PC), were evaluated before and after elective EVAR in 21 patients. Five patients undergoing open AAA repair (OR) were evaluated for comparison.ResultsSuPAR (p < 0.001), ET-1 (p = 0.003) and IL-6 (p = 0.02) increased whereas IgM anti-PC decreased (p < 0.001) after EVAR. Both suPAR (p = 0.04) and IL-6 (p = 0.03) increased in the five patients with unchanged/expanded aneurysm sac after EAR, whereas only suPAR increased (p = 0.04) and IL-6 remained unchanged (p = 0.2) among the 16 patients with shrinking aneurysm sac. No difference was noted between patients undergoing EVAR and OR regarding levels or changes of studied markers.ConclusionsThese changes in plasma biomarker profile are compatible with on-going inflammatory activation in AAA patients after EVAR. The potential role of IL-6 as a plasma biomarker for treatment failure in surveillance programs after EVAR needs to be further evaluated.