The repair of an abdominal aortic aneurysm (AAA) is a high-risk surgical procedure related to hormonal and metabolic stress-related response with an ensuing activation of the inflammatory cascade. In contrast to open repair (OR), endovascular aortic aneurysm repair (EVAR) seems to decrease the postoperative stress by offering less extensive incisions, dissection, and tissue manipulation. However, these beneficial effects may be offset by the release of cytokines and arachidonic acid metabolites during intra-luminal manipulation of the thrombus using catheters in endovascular repair, resulting in systemic inflammatory response (SIR), which is clinically called post-implantation syndrome. In this systematic review we compared OR with EVAR in terms of the post-interventional inflammatory response resulting from alterations in the circulating cytokine levels. We sought to summarize all the latest evidence regarding post-implantation syndrome after EVAR. We searched Medline (PubMed), ClinicalTrials.gov and the Cochrane library for clinical studies reporting on the release of cytokines as part of the inflammatory response after both open/conventional and endovascular repair of the AAA. We identified 17 studies examining the cytokine levels after OR versus EVAR. OR seemed to be associated with a greater SIR than EVAR, as evidenced by the increased cytokine levels, particularly IL-6 and IL-8, whereas IL-1β, IL-10 and TNF-α showed conflicting results or no difference between the two groups. Polyester endografts appear to be positively correlated with the incidence of post-implantation syndrome after EVAR. Future large prospective studies are warranted to delineate the underlying mechanisms of the cytokine interaction in the post-surgical inflammatory response setting.

中文翻译：

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细胞因子作为腹主动脉瘤开放与血管内修复后炎症反应的生物标志物：系统评价。

腹主动脉瘤（AAA）的修复是一种高风险的外科手术，与激素和代谢应激相关的反应有关，并随后激活了炎症级联反应。与开放式修复（OR）相比，血管内主动脉瘤修复（EVAR）似乎通过提供较少的切口，解剖和组织操作来减少术后压力。但是，这些有益作用可能被在腔内修复中使用导管进行腔内血栓腔内操纵期间细胞因子和花生四烯酸代谢物的释放所抵消，从而导致全身性炎症反应（SIR），临床上称之为植入后综合症。在本系统综述中，我们将循环细胞因子水平改变导致的介入后炎症反应与ORV进行了比较。我们试图总结有关EVAR后植入后综合征的所有最新证据。我们在Medline（PubMed），ClinicalTrials.gov和Cochrane库中进行了临床研究报告，报道了在AAA的开放/常规和血管内修复后细胞因子释放作为炎症反应一部分的临床研究。我们确定了17项检查OR或EVAR后细胞因子水平的研究。细胞因子水平升高，尤其是IL-6和IL-8升高，证明OR似乎比EVAR的SIR更高，而IL-1β，IL-10和TNF-α的结果相互矛盾或两者之间没有差异组。聚酯内移植物似乎与EVAR后的植入后综合征的发生率呈正相关。将来需要进行大规模的前瞻性研究，以描述术后炎症反应中细胞因子相互作用的潜在机制。