The inflammatory response and its consequence for the clinical outcome following aortic aneurysm repair

Objective: to review published studies on the outcome of the inflammatory response after abdominal aortic aneurysm (AAA) repair. Methods: a literature search on PubMed was performed. All studies that determined the inflammatory response (cytokine release) after AAA repair were included. The results of the studies and differences between open and endoluminal repair were compared and evaluated. Results: seventeen studies were identified. In most studies the investigated cytokines were TNF-alpha and IL-6. Determination of IL-1 beta, IL-8, TNFsr2 and TNFsr2 were less often performed. TNF-alpha may reflect, but not strictly predict, the clinical outcome in patients with ruptured AAA. IL-6 levels correlate well with the surgical trauma per se. Variations in recorded cytokine release during endovascular AAA repair may depend on the times of blood sampling. Conclusion: both open and endovascular AAA repair provoke a cytokine response. This response is greater during open repair than during endovascular aortic aneurysm exclusion.