EVAR post-implantation syndrome - can hematological values help us?

• Autor(a) principal: Augusto,Rita
• Data de Publicação: 2020
• Outros Autores: Coelho,Nuno, Semião,Ana, Pinto,Evelise, Ribeiro,João, Peixoto,João, Fernandes,Luís, Brandão,Daniel, Canedo,Alexandra
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2020000400285
• topic: Inflammation; Inflammatory response syndrome; Aortic aneurysm; Endovascular procedures; Hemoglobin; Mean corpuscular volume; Red cell distribution width.

Abstract Introduction: Post-implantation syndrome (PIS) is the clinical and biochemical expression of an inflammatory response following endovascular repair of an aortic aneurysm (EVAR). The reported incidence in literature varies from 14-60%. Recentently, a study has demonstrated that red blood cell distribution width (RDW) is an independent biomarker predictor of the PIS in patients submitted to EVAR in the early postoperative period. Methods: Retrospective institutional review of consecutive patients submitted to elective EVAR (January 2015April 2020). The primary outcome was to evaluate the incidence of PIS, defined as fever (>38ºC) and leukocytosis (>12000/¼L), excluding infection complication. The secondary outcomes were to identify the potential role of clinical and biomarker parameters to predict the risk of developing PIS after EVAR. Results and conclusion: According to the inclusion criteria, 107 patients were identified. The median age was 75 years old (93.5% men). Comorbidities presented: hypertension (75%), smoking (66%), hypercholesterolemia (59%), coronary artery disease (32%), chronic kidney disease (30%), and diabetes mellitus (DM) (18%). The incidence of PIS was 10,2%. Age, gender and cardiovascular risk factors were found to be similar in both groups (P>0.05). Regarding the procedure approach, the majority of patients were treated with percutaneous access (72%) (P=0,49). In both groups (PIS vs. no PIS), the hemoglobin values significantly decreased (P=0,04) after surgery by approximately 14%. The same trend was observed for mean corpuscular volume (MCV) (P=0.032), which reflected the increasing of the RDW although not reaching statistical significance. Although delta variation of hemoglobin and delta RDW did not reach statistical significance comparing both groups (P=0,53 and P= 0,07 respectively), delta MCV was found to be significantly lower in the group with PIS (P=0.012). The importance of having a biomarker which measurement allows the prediction of patients who have more risk to develop PIS, may help with the early management of this condition.