Post-implantation syndrome – retrospective analysis of 52 patients

Abstract

Introduction

A systemic inflamatory response is common after EVAR. Its clinical impact is unknown, and although is it usually well tolerated, there is concern it might be associated with increased morbidity and mortality in high risk patients. This study aims to evaluate the occurrence of the post-implantation syndrome (PIS) in patients undergoing EVAR, its characteristics and clinical significance.

Methods

This study is a retrospective observational analysis of patients undergoing elective EVAR between November 2012 and November 2014. PIS was defined by fever (>38 °C) and leukocytosis (>12,000 μL⁻¹), excluding infectious complications. We evaluated the epidemiological characteristics of the patient, aneurysm and procedure characteristics and their relationship with development of PIS.

Results

Fifty-two patients were included, and 21.2% were diagnosed with PIS. The ePTFE grafts were not associated with the occurrence of the syndrome, in contrast with polyester stent grafts (0% vs. 28.2%, p = 0.031). The age and gender of patients, the diameter of the aneurysm, duration and radiation dose and the configuration of the stent graft (aorto-bi-iliac, aorto-uni-iliac or fenestrated) were not associated with PIS. There was no statistically significant difference in the occurrence of major cardiovascular events during hospitalization in both groups.

Conclusion

The inflammatory syndrome after EVAR occurs in a significant percentage of patients (21%). Stent grafts constructed by polyester are a significant risk factor. Despite the exuberant inflammatory response, it was not associated with increased occurrence of cardiovascular events, and it is usually benign, well tolerated and self-limiting.