Purpose: To evaluate the differential effects of endograft fabric types
on pulse wave velocity (PWV), a valid, clinically feasible marker of
arterial stiffness, in patients undergoing endovascular repair (EVAR) of
abdominal aortic aneurysms (AAAs).
Methods: As part of a registered study,118 consecutive men (mean age
7168 years) with AAA undergoing elective EVAR were divided into groups
according to the type of fabric in the implanted endografts: 46 had
polytetrafluoroethylene (PTFE)-covered stent-grafts and 72 received
stent-grafts covered with polyester fabric. Patients with Marfan
syndrome, collagen-related disorders, and end-stage renal failure were
excluded. PWV, clinical characteristics (comorbidities, body mass index,
blood pressure, lipids, and glucose profile), novel biomarkers
[interleukin (IL)-6, IL-8, IL-10, and osteoprotegerin OPG)] were
determined at baseline and prospectively after 12 months.
Results: At baseline, standard multiple regression analysis revealed the
independent association of mean blood pressure, OPG, and AAA diameter
with PWV after adjustment for age (R-2=0.729, p=0.036). At follow-up,
serum levels of both IL-8 and IL-10 were significantly increased, while
OPG decreased in both groups (p<0.05). However, between-group comparison
revealed a more adverse effect of polyester covered endografts on serum
IL8 (p=0.001) and OPG (p=0.048) levels. At the same time, PWV was
considerably increased in both polyester (+4.12 +/- 60.33 m/s, p<0.001)
and PTFE (+2.82 +/- 0.25 m/s, p=0.003) groups; the effect was more
pronounced in the former group (p=0.033). In multivariate analysis, the
polyester endograft type emerged as an independent determinant of PWV
change after EVAR (R-2=0.460, p=0.040).
Conclusion: Both endograft types increased PWV, while recipients of
polyester covered stent-grafts showed greater PWV elevation. Further
investigation will clarify the inflammatory response and the
differential clinical impact of endograft types.
(EN)
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