ISCHEMIA-REPERFUSION SYNDROME AND RESULTS OF OPEN AND ENDOVASCULAR REPAIR OF INFRARENAL ABDOMINAL AORTIC ANEURYSM

Abstract

In the period from March 2013 to May 2014, in order to study the syndrome of ischemia-reperfusion and immediate treatment results, a prospective non-randomized clinical study of 43 patients with infrarenal abdominal aortic aneurysm (AAA) was realized. The patients, depending on the method of treatment, divided into 2 groups: 26 patients with open repair (OR) and 17 patients with endovascular repair (EVAR). The main criteria for inclusion into the study were AAA of II and III type by A. V. Pokrovsky and elective repair of the AAA. As markers of ischemia-reperfusion C-reactive protein, proinflammatory cytokine IL-6, anti-inflammatory cytokine IL-10 and oxidative status were investigated. The level of ischemic inflammation and reperfusion markers in patients with OR was generally higher than in patients with EVAR, and the level of IL-6 excess was statistically significant (p = 0.001). The longer the time compression of the abdominal aorta in the OR the higher the level of markers of ischemia-reperfusion. In patients with a time compression of the abdominal aorta more than 30 minutes there was a significant excess of IL-6 before removing the clamp from the abdominal aorta (p = 0.035) and after the start of the magistral blood flow to both lower extremities (p = 0.050), as well as significant excess of indicator of oxidative status of the blood Oxystat before removing the clamp from the abdominal aorta, after the launch of the main blood flow to the feet and 30 minutes after the end of surgery (p = 0.001). The number of local and systemic complications at the early postoperative period was significantly higher in patients undergoing OR (p = 0.002), which for this indicator shows the benefits of EVAR.