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A Global Assessment of the Inflammatory Response Elicited Upon Open Abdominal Aortic Aneurysm Repair

Vascular Unit, 3rd Department of Surgery, University Hospital 'Attikon', Athens University Medical School, Athens, vas25{at}otenet.gr

Marianna Argentou, MD

Critical Care Unit, University of Patras School of Medicine, Patras

John D. Kakisis, MD

Vascular Unit, 3rd Department of Surgery, University Hospital 'Attikon', Athens University Medical School, Athens

Apostolos Bossios, MD

Department of Pediatrics Research Laboratory, Aglaia Kyriakou Hospital, Athens University Medical School, Athens, Greece

Dimitrios Gourgiotis

Department of Pediatrics Research Laboratory, Aglaia Kyriakou Hospital, Athens University Medical School, Athens, Greece, dgourg{at}med.uoa.gr

Menelaos Karanikolas, MD, MPH

Critical Care Unit, University of Patras School of Medicine, Patras

Gabriel Karatzas, MD

Vascular Unit, 3rd Department of Surgery, University Hospital 'Attikon', Athens University Medical School, Athens

The inflammatory response during elective open infrarenal abdominal aortic aneurysm repair and its impact on outcome is investigated. Twenty high-risk patients were enrolled, and blood samples were obtained at 8 perioperative time points. Endotoxin, cytokines (tumor necrosis factor- and interleukin-1β, and interleukin-6), CD11b expression, and nitric oxide were measured. Peak endotoxin levels occurred within 30 minutes of reperfusion and were higher among patients developing complications. Interleukin-6 levels increased during reperfusion, reaching a peak on the first postoperative day. Interleukin-6 increase correlated with aortic clamp time and morbidity. CD11b expression increased 30 minutes after reperfusion, and this effect was greater among patients who developed complications. Endotoxin may be important in the pathogenesis of multiple organ dysfunction syndrome. Activated neutrophils may have a central role in tissue injury after reperfusion. Intraoperative CD11b upregulation may be an early marker for postoperative complications after infrarenal abdominal aortic aneurysm repair.

Key Words: aortic aneurysm • abdominal • inflammation • interleukins • postoperative period • endotoxin • tumor necrosis factor

Vascular and Endovascular Surgery, Vol. 42, No. 1, 47-53 (2008)
DOI: 10.1177/1538574407308942


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