Article
Intraluminal assessment of inflammatory factors in patients with intracranial aneurysm
Intraluminale Beurteilung von Entzündungsfaktoren bei Patienten mit intrakraniellem Aneurysma
Search Medline for
Authors
-
Spyros Boulieris
- University Hospital of Patras, Department of Neurosurgery, Patra, Griechenland
-
Petros Zampakis
- University Hospital of Patras, Interventional Neuroradiology, Patra, Griechenland
-
Ioannis Panagoulias
- University Hospital of Patras, Laboratory of Immunohematology, Division of Hematology,Department of Internal Medicine, Patra, Griechenland
-
Athanasia Mouzaki
- University Hospital of Patras, Laboratory of Immunohematology, Division of Hematology,Department of Internal Medicine, Patra, Griechenland
-
Constantinos Constantoyannis
- University Hospital of Patras, Department of Neurosurgery, Patra, Griechenland
-
Vasileios Panagiotopoulos
- University Hospital of Patras, Department of Neurosurgery / Endovascular Neurosurgery, Patra, Griechenland
| Published: | May 25, 2022 |
|---|
Outline
Text
Objective: The formation, growth and rupture of intracranial aneurysm (IA) is the result of many different factors and pathophysiological mechanisms, including focal hemodynamic injury and inflammation of the arterial wall. Our aim was to investigate the differences between venous, parent artery and intra-aneurysmal blood in terms of levels of inflammatory factors in patients with ruptured (rIA) or unruptured intracranial aneurysms (uIA).
Methods: A prospective study was performed in patients who presented with a IA and required endovascular treatment. Patients were divided into 2 groups: Group A included patients with uIA and group B included patients with rIA. Blood was drawn from 3 sources in each patient: the lumen of the aneurysm sac, the parent artery, and the peripheral veins. The concentrations of inflammatory factors C3, C4 (proteins of the complement system), IgG, IgM, IgA (antibodies), and CRP were evaluated in our laboratory for each sample. We compared the concentrations of inflammatory factors in venous, parent artery and intra-aneurysmal serum samples in each group and between the two groups.
Results: A total of 36 patients (15 patients with uIA and 21 patients with rIA) were enrolled in our study within 14 months. In both groups, C3, C4, IgM, IgG and IgA showed a gradual decrease from venous to intraneurysmal samples, but only IgG concentrations in the parent artery and intra-aneurysmal samples reached a statistically significant decrease in uIA compared to venous samples (p<0.05). Accordingly, C3 and IgG concentrations in the intra-aneurysmal samples showed statistically significant decrease in rIA compared to venous samples (p<0.05). When comparing the two groups, the results showed a statistically significant increase in CRP concentrations in the parent artery and intra-aneurysmal samples from patients with rIA compared to the samples from patients with uIA (p<0.001)
Conclusion: Our results showed decreased concentrations of C3 and IgG within the aneurysm sac, indicating activation of the complement system within the arterial wall. CRP concentrations in the aneurysm sac and in the lumen of the parent artery were significantly increased in ruptured aneurysms compared with unruptured aneurysms. These findings support the role of an ongoing inflammatory process in both ruptured and unruptured aneurysms leading to their growth and rupture.
