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Michalska M, Grochowiecki T, Wyczałkowska-Tomasik A, Pączek L, Jakimowicz T, Cacko A, Jama K, Stec A, Sikorska E, Nazarewski S, Gałązka Z. Evaluation of selected parameters of inflammation, coagulation system, and formation of extracellular neutrophil traps (NETs) in the perioperative period in patients undergoing endovascular treatment of thoracoabdominal aneurysm with a branched device (t-Branch). Front Cardiovasc Med 2023; 10:1153130. [PMID: 37745097 PMCID: PMC10513084 DOI: 10.3389/fcvm.2023.1153130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 08/17/2023] [Indexed: 09/26/2023] Open
Abstract
Extracellular Neutrophils Traps (NETs) and their formation, known as NETosis, have become pivotal in the pathogenesis of aortic aneurysm development. This study investigates the NETosis markers with the assessment of selected parameters of inflammation and coagulation system in patients with thoracoabdominal aortic aneurysms in the pre-and postop period undergoing t-Branch stent-graft implantation. The study included 20 patients with thoracoabdominal aortic aneurysms. Three markers double-stranded DNA (dsDNA), single-stranded DNA (ssDNA), and citrullinated H3 histones (Cit-H3) were tested at three-time points from patients' blood. The parameters of NETosis, inflammation, and coagulation system were examined in the preoperative period (within 24 h before surgery) and in the postoperative period (on the 3rd and 5th postoperative day). Free-circulating DNA (cfDNA) was isolated from the blood using the MagMAXTM Cell-Free DNA Extraction Kit. Double-stranded DNA (dsDNA) and single-stranded DNA (ssDNA) were then quantified using the Qubit dsDNA HS Assay Kit and the Qubit ssDNA Assay Kit. Cit-H3 concentration was determined by enzyme immunoassay ELISA (Cayman). The results revealed the significance of NETs secretion in response to the complex processes after stent-graft implantation. All NET markers increased shortly after surgery, with histones being the first to return to preoperative levels. The lack of normalization of dsDNA and ssDNA levels to preoperative levels by the last postoperative blood collection demonstrates NETs reorganization. The increase in the number of neutrophils was not related to the expansion of postoperative NETosis. The study reveals a new marker of NETosis, ssDNA, that has not been studied so far. The implantation of a stent graft in a patient with TAAA triggers an inflammatory response manifested by an increase in inflammatory parameters. One of the hallmarks of inflammation is the activation of neutrophil extracellular traps.
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Affiliation(s)
- Milena Michalska
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Tadeusz Grochowiecki
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | | | - Leszek Pączek
- Department of Immunology, Transplantology, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Jakimowicz
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Cacko
- Department of Medical Informatics and Telemedicine, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Jama
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Albert Stec
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Ewa Sikorska
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Sławomir Nazarewski
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Zbigniew Gałązka
- Department of General, Vascular, Endocrine and Transplant Surgery, Medical University of Warsaw, Warsaw, Poland
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Nakamura H, Kanki A, Watanabe H, Ono K, Kuwada N, Saisho S, Nishimura H, Yamamoto A, Tamada T. A case of primary aortic sarcoma with tumor infarction after stent graft placement. Acta Radiol Open 2021; 10:20584601211063360. [PMID: 34900342 PMCID: PMC8664319 DOI: 10.1177/20584601211063360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/12/2021] [Indexed: 12/02/2022] Open
Abstract
Primary aortic sarcoma is a very rare disease, and most primary aortic tumors are
malignant mesenchymal tumors. We present the case of a 62-year-old man with
sudden epigastric and back pain. Contrast-enhanced computed tomography (CT)
revealed a mass lesion about 33.8 mm in diameter, in contact with the left side
of the abdominal aorta. Impending rupture of an abdominal aortic aneurysm was
suspected, so cardiovascular surgery for stent graft placement was performed the
same day. Symptoms immediately improved and CT at 3 months postoperatively
showed a marked decrease in lesion size, but the lesion subsequently grew again.
Fluorodeoxyglucose (FDG)-positron emission tomography/CT was performed due to
the possibility of malignant solid tumor, revealing markedly increased FDG
accumulation (maximum standardized uptake value, 36.95) in the mass lesion.
Primary aortic sarcoma was diagnosed from thoracoscopic biopsy. Here, we report
a primary aortic sarcoma that shrank due to tumor infarction after stent graft
placement, followed by tumor regrowth.
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Affiliation(s)
- Hiroki Nakamura
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - Akihiko Kanki
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | | | - Kentarou Ono
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - Noriaki Kuwada
- Department of Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Japan
| | - Shinsuke Saisho
- Department of General Thoracic Surgery, Kawasaki Medical School, Kurashiki, Japan
| | | | - Akira Yamamoto
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Japan
| | - Tsutomu Tamada
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Japan
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