Inflammatory Response in Open and Endovascular Treatment

2006

2007

Variable

Open repair (%)

TEVAR

95 % CI

p value

Open repair (%)

TEVAR (%)

95 % CI

p value

In-hospital mortality

9.79

1.16 %

8.48

(3.03–23.75)

<0.01

1.35

1.91

0.71

(0.12–4.24)

0.7

Cardiac complications

7.13

1.22 %

5.5

(1.34–25.48)

0.02

10.85

2.02

5.36

(1.82–15.81)

<0.01

Transfusion

32.52

15.77

2.06

(1.22–3.48)

<0.01

29.36

20.68

1.42

(0.77–2.63)

0.26

Hematoma

2.91

–

1.35

3.85

0.35

(0.07–2.63)

0.22

Hemorrhage

7.13

3.45

2.07

(0.41–10.46)

0.38

5.28

1.69

3.12

(0.43–22.71)

0.26

Respiratory complications

23.37

8.29 %

2.82

(1.27–6.25)

0.01

16.01

6.92

2.31

(0.96–5.56)

0.06

Prolonged ventilation

13.41

1.98 %

6.78

(1.51–30.51)

0.01

10.70

2.32

4.61

(0.99–21.46)

0.05

Tracheostomy

0.00

–

7.51

1.91

3.92

(0.79–19.53)

0.09

Acute renal failure

8.35

3.52

2.37

(0.75–7.46)

0.14

6.53

5.16

1.26

(0.29–5.44)

0.75

Postop stroke/TIA

3.66

2.66 %

1.38

(0.31–6.14)

0.67

0.30

2.05

0.14

(0.02–1.36)

0.09

PVC

2.44

4.61 %

0.53

(0.07–4.28)

0.55

0.25

1.78

0.14

(0.01–1.29)

0.08

Sepsis

0.00

0.00 %

–

0.00

0.34

–

Graft problem

2.85

4.76 %

0.60

(0.09– 4.01)

0.60

4.05

6.96

0.61

(0.12–3.17)

0.55

CI 95 % confidence interval, PVC peripheral vascular complication, RR estimated relative risk, TEVAR thoracic endovascular aortic repair, TIA transient ischemic attack

The endovascular aortic approach is not free of complications, particularly inflammation. In an attempt to prove this, Gabriel et al. [12] developed clinical research whose main focus was to try to determine the magnitude, intensity, and correlations of the inflammatory response theoretically speculated for the setting of endovascular procedures. The main outcomes of this study are illustrated in Figs. 43.1, 43.2, 43.3, 43.4, 43.5, 43.6, and 43.7. Concerning these figures, we must bear in mind that there is something like an inflammatory response pattern following the deployment of aortic endoprostheses. This pattern is represented by a profile of inflammatory markers as well as “inflammatory time courses” for each marker [12].