Importance of Biomarkers in Determining Post-Implantation Syndrome Developing Due to Endovascular Aneurysm Repair

Abstract

Objectives: In this study, we aimed to undertake a systematic review of the literature in order to investigate whetherpreoperative biomarkers have diagnostic significance in determining post-implantation syndrome PIS possibility afterendovascular aneurysm repair (EVAR).Methods: Literature review was carried out in PubMed electronic database without any limitations of date. Includedwere studies that recorded the preoperative levels of inflammatory biomarkers in which PIS develops following EVARand that were published only in English. Results of the studies were evaluated based on either random or fixed effectmodel in accordance with the presence of heterogeneity (I2>25%). Statistical analysis were performed by Open metaAnalyst® software.Results: A total of 349 articles were found upon a database screening. After the article titles and abstracts were analysed, 6 articles were included in the meta-analysis that cover 891 patients and comply with inclusion criteria. It wasobserved in the studies that WBC, CRP, thrombocyte, IL-6, and fibrinogen levels were analysed. It was found from theconducted analysis that the preoperative levels of WBC (SMD: 0.70 95% CI: 0.55-0.86 and p<0.001), fibrinogen (SMD:0.27 95% CI: 0.03-0.51 and p=0.02), IL-6 (SMD: 1.04 95% CI: 0.64-1.44 and p<0.001), and thrombocyte (SMD: 0.91 95% CI:0.13-0.69 and p=0.02) were significant in determining the PIS development, however, CRP levels were not (SMD: 0.3795% CI: -0.20-0.96 and p=0.20).Conclusion: We concluded that WBC, thrombocyte, fibrinogen, and IL-6 levels were effective in predicting PIS developing after EVAR in preoperative period.