Local inflammatory reaction and perianeurysmal fibrosis after endovascular aortic repair

Aim: The aim of this study was to asses the presence of a periaortic inflammatory response after endovascular abdominal aortic repair (EVAR) that could lead to periaortic fibrosis (PAF). Meterials and Methods: To reveal the presence of an early post-procedural inflammatory reaction after EVAR a scintigraphic examination was performed using a radiodiagnostic agent consisting of a murine monoclonal antibody Fab fragment, towards activated granulocytes. The scintigraphy was performed 24 hours before the procedure and 72 hours after. The dual phase contrast CT-scan was used to detect the presence of PAF, defined as a thickening of the aortic wall of minimum 1 mm. The Ct scan was performed 1 month after the procedure and thereafter at 6,12 months and then yearly. Results: In 20 patients a preoperative and postoperative scintigraphy was performed. In all cases no differences were observed between the preoperative and postoperative scintigraphy. Particularly no areas of fixation of the radio diagnostic agent emerged in the aortic region, in none o these patients a PAF was observed at the CT scan performed during the follow-up (mean 48 months). To show the presence of a PAF after EVAR the preoperative and postoperative Ct scan (at 1, 6 and 12 months), were review in 100 patients: in none of these cases a PAF was observed. Conclusions: Results of this study seems to demonstrate that is not an early inflammatory response after EVAR in the aortic region detectable at the scintigraphy with a radiodiagnostic agent towards activated granulocytes, that endograft deployment it is not responsible of new cases of PAF at 12 months of follow-up.