Dynamics of inflammatory biomarkers after femoropopliteal revascularization: a prospective pilot study

    Authors

    Keywords

    peripheral arterial disease, endovascular revascularisation, inflammatory biomarkers, interleukin

    DOI

    https://doi.org/10.15836/ccar2025.246

    Full Text

    **Introduction**: Peripheral arterial disease of the lower limb (PAD) is one of the most common clinical manifestations of atherosclerosis,which is an inflammation-driven process. Patients with PAD exhibit elevated baseline levels of inflammatory markers compared to the healthy population (1). Revascularisation interventions cause an additional, acute increase in circulating inflammatory markers due to arterial wall injury. These markers mediate inflammatory and coagulation responses and are considered an early indicator of potential restenosis (2). Successful revascularisation restores limb perfusion and can lead to a mid- and long-term reductions in inflammatory markers (3). In this observational prospective pilot study, we aimed to investigate the dynamics of circulating inflammatory biomarkers in the first three months after revascularisation. **Patients and Methods**: The study was conducted in the Catheterisation Laboratory of the Department of Vascular Diseases, University Medical Centre Ljubljana, Slovenia. Patients with successful percutaneous femoropopliteal revascularisation due to limiting intermittent claudication were included. Levels of interleukins 6 (IL-6), 8 (IL-8), and 10 (IL-10), C-reactive protein (CRP), and tumour-necrosis factor alpha (TNFα) were determined one hour before the procedure, one day after the procedure, and three months after the procedure. **Results**: Among 28 participants, aged 50-79 years (median 69 years), 18 (64.3%) were male. Statistically significant differences among the three blood samples were observed for IL-6 (p<0.001), IL-10 (p=0.012), and TNFα (p=0.016). For IL-6, differences were present between all three time points: 1st vs 2nd (p=0.011), 2nd vs 3rd (p<0.001), and 1st vs 3rd (p<0.001). A difference between the 2nd and 3rd time point was also observed for IL-10 (p=0.004) and TNFα (p=0.026). **Conclusion**: Restoration of blood flow appears to modulate systemic inflammatory activity and may potentially slow both local and systemic progression of atherosclerosis. More research is needed to determine implications of revascularisation procedures on short- and long-term biomarker levels and their correlation with clinical outcomes.

    Literature

    1. Kaya AD, Kaya ENM, Alnur I. Comparison of inflammatory biomarkers between peripheral artery disease patients and healthy individuals. Cardiovasc Surg Int. 2024;11(3):183–92. https://doi.org/10.5606/e-cvsi.2024.1694
    2. Schillinger M, Exner M, Mlekusch W, Rumpold H, Ahmadi R, Sabeti S, et al. Vascular inflammation and percutaneous transluminal angioplasty of the femoropopliteal artery: association with restenosis. Radiology. 2002 October;225(1):21–6. https://doi.org/10.1148/radiol.2251011809
    3. Poredoš P, Poredoš P, Cevc M, Fareed J, Boc V. Revascularization of Peripheral Arteries in Patients with Intermittent Claudication Decreases Inflammatory Biomarkers. Clin Appl Thromb Hemost. 2023 January-December;29:10760296231176815. https://doi.org/10.1177/10760296231176815
    Cardiologia Croatica
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    Dynamics of inflammatory biomarkers after femoropopliteal revascularization: a prospective pilot study

    Extended Abstract
    Issue9-10
    Published
    Pages246
    PDF via DOIhttps://doi.org/10.15836/ccar2025.246
    peripheral arterial disease
    endovascular revascularisation
    inflammatory biomarkers
    interleukin

    Authors

    Anja Boc*ORCIDUniversity Clinical Centre Ljubljana, Ljubljana, Slovenia
    Mojca Božič MijovskiORCIDUniversity Clinical Centre Ljubljana, Ljubljana, Slovenia
    Vinko BocORCIDUniversity Clinical Centre Ljubljana, Ljubljana, Slovenia
    Kevin PeliconORCIDUniversity Clinical Centre Ljubljana, Ljubljana, Slovenia
    Ula DobovičnikUniversity of Ljubljana, Ljubljana, Slovenia
    Maja GlogovšekUniversity of Ljubljana, Ljubljana, Slovenia

    *Correspondence email: anja.boc@mf.uni-lj.si

    Full Text

    Introduction: Peripheral arterial disease of the lower limb (PAD) is one of the most common clinical manifestations of atherosclerosis,which is an inflammation-driven process. Patients with PAD exhibit elevated baseline levels of inflammatory markers compared to the healthy population (1). Revascularisation interventions cause an additional, acute increase in circulating inflammatory markers due to arterial wall injury. These markers mediate inflammatory and coagulation responses and are considered an early indicator of potential restenosis (2). Successful revascularisation restores limb perfusion and can lead to a mid- and long-term reductions in inflammatory markers (3). In this observational prospective pilot study, we aimed to investigate the dynamics of circulating inflammatory biomarkers in the first three months after revascularisation.

    Patients and Methods: The study was conducted in the Catheterisation Laboratory of the Department of Vascular Diseases, University Medical Centre Ljubljana, Slovenia. Patients with successful percutaneous femoropopliteal revascularisation due to limiting intermittent claudication were included. Levels of interleukins 6 (IL-6), 8 (IL-8), and 10 (IL-10), C-reactive protein (CRP), and tumour-necrosis factor alpha (TNFα) were determined one hour before the procedure, one day after the procedure, and three months after the procedure.

    Results: Among 28 participants, aged 50-79 years (median 69 years), 18 (64.3%) were male. Statistically significant differences among the three blood samples were observed for IL-6 (p<0.001), IL-10 (p=0.012), and TNFα (p=0.016). For IL-6, differences were present between all three time points: 1st vs 2nd (p=0.011), 2nd vs 3rd (p<0.001), and 1st vs 3rd (p<0.001). A difference between the 2nd and 3rd time point was also observed for IL-10 (p=0.004) and TNFα (p=0.026).

    Conclusion: Restoration of blood flow appears to modulate systemic inflammatory activity and may potentially slow both local and systemic progression of atherosclerosis. More research is needed to determine implications of revascularisation procedures on short- and long-term biomarker levels and their correlation with clinical outcomes.

    Literature

    1. 1.
      Kaya AD, Kaya ENM, Alnur I. Comparison of inflammatory biomarkers between peripheral artery disease patients and healthy individuals. Cardiovasc Surg Int. 2024;11(3):183–92.DOI
    2. 2.
      Schillinger M, Exner M, Mlekusch W, Rumpold H, Ahmadi R, Sabeti S, et al. Vascular inflammation and percutaneous transluminal angioplasty of the femoropopliteal artery: association with restenosis. Radiology. 2002 October;225(1):21–6.DOI
    3. 3.
      Poredoš P, Poredoš P, Cevc M, Fareed J, Boc V. Revascularization of Peripheral Arteries in Patients with Intermittent Claudication Decreases Inflammatory Biomarkers. Clin Appl Thromb Hemost. 2023 January-December;29:10760296231176815.DOI