Postimplantation syndrome after endovascular aortic repair: Impact of endograft material and a review of the literature

Aim: Postimplantation syndrome (PIS) is a systemic inflammatory response occurring acutely after endovascular aneurysm repair (EVAR), with reported incidence ranging from 14% to 60%. This study aimed to evaluate the association of different endograft materials with the manifestation and severity of...

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Main Authors: Bahadir Aytekin, Hakki Zafer Iscan
Format: Article
Language:English
Published: Turkish National Vascular and Endovascular Surgery Society 2024-03-01
Series:Turkish Journal of Vascular Surgery
Subjects:
Online Access:https://turkishjournalofvascularsurgery.org//?mno=207177
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author Bahadir Aytekin
Hakki Zafer Iscan
author_facet Bahadir Aytekin
Hakki Zafer Iscan
author_sort Bahadir Aytekin
collection DOAJ
description Aim: Postimplantation syndrome (PIS) is a systemic inflammatory response occurring acutely after endovascular aneurysm repair (EVAR), with reported incidence ranging from 14% to 60%. This study aimed to evaluate the association of different endograft materials with the manifestation and severity of PIS and the role of thrombus formation with type II endoleak incidence. Material and Methods: A retrospective analysis was performed on data from patients who underwent elective EVAR between January 2021 and January 2024. After applying inclusion and exclusion criteria, 171 patients were included. The patients had a mean age of 70.3±8.6 years and 93% were male. Patients were divided into PIS and Non-PIS groups, with a subgroup analysis within the PIS group comparing polyester and expanded polytetrafluoroethylene (e-PTFE) materials. Patient outcomes post-discharge and within the first-year post-surgery were evaluated. Results: No early mortality was observed. PIS was diagnosed in 39.2% of the patients. There was no significant difference on longer intensive care unit (ICU) or hospital stays among the PIS and Non-PIS groups. The incidence of PIS was significantly higher in the polyester subgroup (60%) compared to the ePTFE subgroup (25%). Univariate logistic regression identified polyester material as the factor associated with PIS (P=0.03). First-year computed tomographic angiography (CTA) follow-ups showed a statistically significant lower incidence of type II endoleak (p=0.01) and higher new thrombus formation (p=0.04) in the polyester group. Conclusion: Following EVAR, the patients experience systemic inflammatory responses influenced by the choice of endograft material. Polyester endografts are associated with a higher incidence of PIS and thrombogenicity but a lower incidence of type II endoleak in our study. [Turk J Vasc Surg 2024; 33(2.000): 97-102]
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spelling doaj-art-019e6cda382d4034a7b6a45a54b148432025-02-11T11:13:53ZengTurkish National Vascular and Endovascular Surgery SocietyTurkish Journal of Vascular Surgery2667-50802024-03-0133297102207177Postimplantation syndrome after endovascular aortic repair: Impact of endograft material and a review of the literatureBahadir Aytekin0Hakki Zafer Iscan1Ankara Bilkent Şehir Hastanesi Universiteler Mahallesi 1604. Cadde No: 9 Bilkent Ankara Bilkent Şehir Hastanesi Universiteler Mahallesi 1604. Cadde No: 9 BilkentAim: Postimplantation syndrome (PIS) is a systemic inflammatory response occurring acutely after endovascular aneurysm repair (EVAR), with reported incidence ranging from 14% to 60%. This study aimed to evaluate the association of different endograft materials with the manifestation and severity of PIS and the role of thrombus formation with type II endoleak incidence. Material and Methods: A retrospective analysis was performed on data from patients who underwent elective EVAR between January 2021 and January 2024. After applying inclusion and exclusion criteria, 171 patients were included. The patients had a mean age of 70.3±8.6 years and 93% were male. Patients were divided into PIS and Non-PIS groups, with a subgroup analysis within the PIS group comparing polyester and expanded polytetrafluoroethylene (e-PTFE) materials. Patient outcomes post-discharge and within the first-year post-surgery were evaluated. Results: No early mortality was observed. PIS was diagnosed in 39.2% of the patients. There was no significant difference on longer intensive care unit (ICU) or hospital stays among the PIS and Non-PIS groups. The incidence of PIS was significantly higher in the polyester subgroup (60%) compared to the ePTFE subgroup (25%). Univariate logistic regression identified polyester material as the factor associated with PIS (P=0.03). First-year computed tomographic angiography (CTA) follow-ups showed a statistically significant lower incidence of type II endoleak (p=0.01) and higher new thrombus formation (p=0.04) in the polyester group. Conclusion: Following EVAR, the patients experience systemic inflammatory responses influenced by the choice of endograft material. Polyester endografts are associated with a higher incidence of PIS and thrombogenicity but a lower incidence of type II endoleak in our study. [Turk J Vasc Surg 2024; 33(2.000): 97-102]https://turkishjournalofvascularsurgery.org//?mno=207177endovascular aneurysm repairpostimplantation syndrome
spellingShingle Bahadir Aytekin
Hakki Zafer Iscan
Postimplantation syndrome after endovascular aortic repair: Impact of endograft material and a review of the literature
Turkish Journal of Vascular Surgery
endovascular aneurysm repair
postimplantation syndrome
title Postimplantation syndrome after endovascular aortic repair: Impact of endograft material and a review of the literature
title_full Postimplantation syndrome after endovascular aortic repair: Impact of endograft material and a review of the literature
title_fullStr Postimplantation syndrome after endovascular aortic repair: Impact of endograft material and a review of the literature
title_full_unstemmed Postimplantation syndrome after endovascular aortic repair: Impact of endograft material and a review of the literature
title_short Postimplantation syndrome after endovascular aortic repair: Impact of endograft material and a review of the literature
title_sort postimplantation syndrome after endovascular aortic repair impact of endograft material and a review of the literature
topic endovascular aneurysm repair
postimplantation syndrome
url https://turkishjournalofvascularsurgery.org//?mno=207177
work_keys_str_mv AT bahadiraytekin postimplantationsyndromeafterendovascularaorticrepairimpactofendograftmaterialandareviewoftheliterature
AT hakkizaferiscan postimplantationsyndromeafterendovascularaorticrepairimpactofendograftmaterialandareviewoftheliterature