Should We be Concerned About the Inflammatory Response to Endovascular Procedures?
| Autor: | Djordje Radak, Nenad Djukic, Esma R. Isenovic, Slobodan Tanaskovic, Milan Obradovic, Desanka Cenic-Milosevic |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Anti-Inflammatory Agents Inflammation 030204 cardiovascular system & hematology Fibrinogen Proinflammatory cytokine Blood Vessel Prosthesis Implantation 03 medical and health sciences 0302 clinical medicine Risk Factors Blood vessel prosthesis Internal medicine medicine Animals Humans cardiovascular diseases 030212 general & internal medicine Serum amyloid A Pharmacology business.industry Endovascular Procedures Stent Arteries medicine.disease Abdominal aortic aneurysm Pathophysiology Blood Vessel Prosthesis 3. Good health Surgery Cardiology Stents Inflammation Mediators medicine.symptom Cardiology and Cardiovascular Medicine business Angioplasty Balloon Signal Transduction medicine.drug |
| Zdroj: | Current Vascular Pharmacology. 15:230-237 |
| ISSN: | 1570-1611 |
| DOI: | 10.2174/1570161115666170105121900 |
| Popis: | Endovascular surgery represents a minimally invasive procedure for the treatment of occlusive and aneurysmal arterial disease. However, it is followed by inflammatory response, with a rise in specific inflammatory biomarkers, such as C-reactive protein, serum amyloid A and fibrinogen. Shear stress during balloon inflation and vascular injury represents triggering events for the inflammatory process, stimulating the production of proinflammatory molecules and activation of circulating monocytes. The current literature indicates that stent implantation induces more prominent inflammatory reaction. Additionally, it has been shown that muscular arteries of femoropopliteal segment react to a greater extent to stent implantation, compared with elastic carotid or iliac arteries. The endovascular treatment of thoracic and abdominal aortic aneurysm is frequently followed with post-implantation inflammatory syndrome. Most recent findings point out that stent graft material plays a significant role in the inflammatory response, representing a challenge for clinicians. Future studies should consider the pathophysiology of the inflammatory response associated with endovascular procedures as well as predictors and risk factors including preventive strategies and therapeutic algorithms. Although the potential role of anti-inflammatory drugs after endovascular procedures has been observed, it needs to be validated in upcoming trials. The Neutrophil Lymphocyte Ratio, platelet count, Platelet-to-Lymphocyte Ratio and other biomarkers should be considered in future trials to assess the inflammatory response after endovascular procedures. Inflammatory markers may also become therapeutic targets. |
| Databáze: | OpenAIRE |
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