Polyester Stent Graft Devices and Higher Risk of Post-Implantation Syndrome after EVAR: Single-Center Analysis of 367 Patients

Background: The post-implantation syndrome may occur shortly after endovascular aneurysm repair in patients treated for abdominal aortic aneurysm. Different types of biomaterials may provoke var ying inflammator y responses in patients receiving different endografts. The purpose of this article is to evaluate the PIS after EVAR and the influence of different types of device fabric. Methods: All patients submitted to elective AAA endovascular repair at our institution from January 2014 to December 2019 were enrolled. The PIS was defined by a body temperature of > 38 degrees C and WBC > 12'000/mu l without any evidence of an infection during (48h) the observation period. Results: Three hundred and sixty-seven patients (89% males) were enrolled in this study and post-implantation syndrome occurred in 41 cases (11.2%). The incidence of PIS was significantly higher ( P < 0.001) in patients treated with polyester stent grafts (39/201, 19,4%) compared to patients with PTFE stent grafts (2/166, 1,2%). CRP was related to the presence of PIS with a cutoff values of 109.31 mg/dL ( P = 0.0052). The median in-hospital stay considering the polyester group was 6,2 days, while in the PTFE group it was 5,6 days ( P = 0.04). Conclusions: The postoperative inflammatory response after EVAR seems significantly higher by using polyester stent graft compared to PTFE devices. CRP could be a useful biomarker in defining PIS. Multi-center studies are necessary to confirm these data.