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Residual Aneurysmal Sac Shrinkage Post-Endovascular Aneurysm Repair: The Role of Preoperative Inflammatory Markers

Introduction: In this study, we evaluated the role of preoperative inflammatory markers as Neutrophil-to-Lymphocyte (NLR) and Platelet-to-Lymphocyte (PLR) ratios in relation to post-endovascular aneurysm repair (EVAR) sac shrinkage, which is known to be an important factor for abdominal aortic aneur...

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Autores principales: Pasqui, Edoardo, de Donato, Gianmarco, Molino, Cecilia, Abu Leil, Mustafa, Anzaldi, Manfredi Giuseppe, Galzerano, Giuseppe, Palasciano, Giancarlo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10377044/
https://www.ncbi.nlm.nih.gov/pubmed/37509562
http://dx.doi.org/10.3390/biomedicines11071920
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author Pasqui, Edoardo
de Donato, Gianmarco
Molino, Cecilia
Abu Leil, Mustafa
Anzaldi, Manfredi Giuseppe
Galzerano, Giuseppe
Palasciano, Giancarlo
author_facet Pasqui, Edoardo
de Donato, Gianmarco
Molino, Cecilia
Abu Leil, Mustafa
Anzaldi, Manfredi Giuseppe
Galzerano, Giuseppe
Palasciano, Giancarlo
author_sort Pasqui, Edoardo
collection PubMed
description Introduction: In this study, we evaluated the role of preoperative inflammatory markers as Neutrophil-to-Lymphocyte (NLR) and Platelet-to-Lymphocyte (PLR) ratios in relation to post-endovascular aneurysm repair (EVAR) sac shrinkage, which is known to be an important factor for abdominal aortic aneurysm (AAA) healing. Methods: This was a single-center retrospective observational study. All patients who underwent the EVAR procedure from January 2017 to December 2020 were eligible for this study. Pre-operative blood samples of all patients admitted were used to calculate NLR and PLR. Sac shrinkage was defined as a decrease of ≥5 mm in the maximal sac diameter. The optimal NLR and PLR cut-offs for aneurysmal sac shrinkage were obtained from ROC curves. Stepwise multivariate analysis was performed in order to identify independent risk and protective factors for the absence of AAA shrinkage. Kaplan–Meier curves were used to evaluate survival rates with respect to the AAA shrinkage. Results: A total of 184 patients were finally enrolled. The mean age was 75.8 ± 8.3 years, and 85.9% were male (158/184). At a mean follow-up of 43 ± 18 months, sac shrinkage was registered in 107 patients (58.1%). No-shrinking AAA patients were more likely to be older, to have a higher level of NLR and PLR, and be an active smoker. Kaplan–Meier curves highlighted a higher rate of survival for shrinking AAA patients with respect to their counterparts (p < 0.03). Multivariate analysis outlined active smoking and NLR as independent risk factors for no-shrinking AAA. Conclusions: Inflammation emerged as a possible causative factor for no-shrinking AAA, playing a role in aneurysmal sac remodeling. This study revealed that inflammatory biomarkers, such as NLR and PLR, can be used as a preoperative index of AAA sac behavior after EVAR procedures.
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spelling pubmed-103770442023-07-29 Residual Aneurysmal Sac Shrinkage Post-Endovascular Aneurysm Repair: The Role of Preoperative Inflammatory Markers Pasqui, Edoardo de Donato, Gianmarco Molino, Cecilia Abu Leil, Mustafa Anzaldi, Manfredi Giuseppe Galzerano, Giuseppe Palasciano, Giancarlo Biomedicines Article Introduction: In this study, we evaluated the role of preoperative inflammatory markers as Neutrophil-to-Lymphocyte (NLR) and Platelet-to-Lymphocyte (PLR) ratios in relation to post-endovascular aneurysm repair (EVAR) sac shrinkage, which is known to be an important factor for abdominal aortic aneurysm (AAA) healing. Methods: This was a single-center retrospective observational study. All patients who underwent the EVAR procedure from January 2017 to December 2020 were eligible for this study. Pre-operative blood samples of all patients admitted were used to calculate NLR and PLR. Sac shrinkage was defined as a decrease of ≥5 mm in the maximal sac diameter. The optimal NLR and PLR cut-offs for aneurysmal sac shrinkage were obtained from ROC curves. Stepwise multivariate analysis was performed in order to identify independent risk and protective factors for the absence of AAA shrinkage. Kaplan–Meier curves were used to evaluate survival rates with respect to the AAA shrinkage. Results: A total of 184 patients were finally enrolled. The mean age was 75.8 ± 8.3 years, and 85.9% were male (158/184). At a mean follow-up of 43 ± 18 months, sac shrinkage was registered in 107 patients (58.1%). No-shrinking AAA patients were more likely to be older, to have a higher level of NLR and PLR, and be an active smoker. Kaplan–Meier curves highlighted a higher rate of survival for shrinking AAA patients with respect to their counterparts (p < 0.03). Multivariate analysis outlined active smoking and NLR as independent risk factors for no-shrinking AAA. Conclusions: Inflammation emerged as a possible causative factor for no-shrinking AAA, playing a role in aneurysmal sac remodeling. This study revealed that inflammatory biomarkers, such as NLR and PLR, can be used as a preoperative index of AAA sac behavior after EVAR procedures. MDPI 2023-07-06 /pmc/articles/PMC10377044/ /pubmed/37509562 http://dx.doi.org/10.3390/biomedicines11071920 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pasqui, Edoardo
de Donato, Gianmarco
Molino, Cecilia
Abu Leil, Mustafa
Anzaldi, Manfredi Giuseppe
Galzerano, Giuseppe
Palasciano, Giancarlo
Residual Aneurysmal Sac Shrinkage Post-Endovascular Aneurysm Repair: The Role of Preoperative Inflammatory Markers
title Residual Aneurysmal Sac Shrinkage Post-Endovascular Aneurysm Repair: The Role of Preoperative Inflammatory Markers
title_full Residual Aneurysmal Sac Shrinkage Post-Endovascular Aneurysm Repair: The Role of Preoperative Inflammatory Markers
title_fullStr Residual Aneurysmal Sac Shrinkage Post-Endovascular Aneurysm Repair: The Role of Preoperative Inflammatory Markers
title_full_unstemmed Residual Aneurysmal Sac Shrinkage Post-Endovascular Aneurysm Repair: The Role of Preoperative Inflammatory Markers
title_short Residual Aneurysmal Sac Shrinkage Post-Endovascular Aneurysm Repair: The Role of Preoperative Inflammatory Markers
title_sort residual aneurysmal sac shrinkage post-endovascular aneurysm repair: the role of preoperative inflammatory markers
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10377044/
https://www.ncbi.nlm.nih.gov/pubmed/37509562
http://dx.doi.org/10.3390/biomedicines11071920
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