S-100 and Antioxidant Capacity in Cerebrospinal Fluid During and After Thoracic Endovascular Aortic Repair

Overview

Journal Int Sch Res Notices

Specialty Biology

Date 2017 Jul 26

PMID 28740858

Citations 1

Authors

Koichiro Nandate

Deepak Sharma

Hernando Olivar

Matthew Hallman

Ramesh Ramaiah

Aaron Joffe

Anthony Roche

Vijay Krishnamoorthy

Affiliations

Soon will be listed here.

Abstract

Background: Thoracic Endovascular Aortic Repair (TEVAR) has substantially decreased the mortality and major complications from aortic surgery. However, neurological complications such as spinal cord ischemia may still occur after TEVAR. S-100 is a biomarker of central nervous system injury, and oxidant injury plays an important role in neurological injury. In this pilot study, we examined the trends of S-100 and antioxidant capacity in the CSF during and after TEVAR.

Methods: We recruited 10 patients who underwent elective TEVAR. CSF samples were collected through a lumbar catheter at the following time points: before the start of surgery (0) and immediately (1) and 24 (2) and 48 hours (3) after the deployment of the aortic stent. S-100 and CSF antioxidant capacity were analyzed with the use of commercially available kits.

Results: We observed that the level of S-100 in all of the subjects at 24 hours after the deployment of the aortic stent (2) increased. However, the levels of S-100 at 1 and 3 were comparable to the baseline value. The antioxidant capacity remained unchanged. No patient had a clinical neurologic complication.

Conclusions: Our observations may indicate biochemical/subclinical central nervous system injury attributable to the deployment of the aortic stent.

Citing Articles

Biomarkers of Spinal Cord Injury in Patients Undergoing Complex Endovascular Aortic Repair Procedures-A Narrative Review of Current Literature.

Sotir A, Klopf J, Brostjan C, Neumayer C, Eilenberg W Biomedicines. 2023; 11(5).

PMID: 37238988 PMC: 10216375. DOI: 10.3390/biomedicines11051317.

References

Khoynezhad A, Donayre C, Bui H, Kopchok G, Walot I, White R . Risk factors of neurologic deficit after thoracic aortic endografting. Ann Thorac Surg. 2007; 83(2):S882-9. DOI: 10.1016/j.athoracsur.2006.10.090. View

Bobadilla J, Wynn M, Tefera G, Acher C . Low incidence of paraplegia after thoracic endovascular aneurysm repair with proactive spinal cord protective protocols. J Vasc Surg. 2013; 57(6):1537-42. DOI: 10.1016/j.jvs.2012.12.032. View

Morales J, Taylor P, Bell R, Chan Y, Sabharwal T, Carrell T . Neurological complications following endoluminal repair of thoracic aortic disease. Cardiovasc Intervent Radiol. 2007; 30(5):833-9. DOI: 10.1007/s00270-007-9017-6. View

Jia Z, Zhu H, Li J, Wang X, Misra H, Li Y . Oxidative stress in spinal cord injury and antioxidant-based intervention. Spinal Cord. 2011; 50(4):264-74. DOI: 10.1038/sc.2011.111. View

Bloomfield S, McKinney J, Smith L, Brisman J . Reliability of S100B in predicting severity of central nervous system injury. Neurocrit Care. 2007; 6(2):121-38. DOI: 10.1007/s12028-007-0008-x. View

Bains M, Hall E . Antioxidant therapies in traumatic brain and spinal cord injury. Biochim Biophys Acta. 2011; 1822(5):675-84. PMC: 4134010. DOI: 10.1016/j.bbadis.2011.10.017. View

Hall E . Antioxidant therapies for acute spinal cord injury. Neurotherapeutics. 2011; 8(2):152-67. PMC: 3101837. DOI: 10.1007/s13311-011-0026-4. View

Sullivan T, Sundt 3rd T . Complications of thoracic aortic endografts: spinal cord ischemia and stroke. J Vasc Surg. 2006; 43 Suppl A:85A-88A. DOI: 10.1016/j.jvs.2005.10.048. View

Khaladj N, Teebken O, Hagl C, Wilhelmi M, Tschan C, Weissenborn K . The role of cerebrospinal fluid S100 and lactate to predict clinically evident spinal cord ischaemia in thoraco-abdominal aortic surgery. Eur J Vasc Endovasc Surg. 2008; 36(1):11-9. DOI: 10.1016/j.ejvs.2008.01.011. View

10.

Wan I, Angelini G, Bryan A, Ryder I, Underwood M . Prevention of spinal cord ischaemia during descending thoracic and thoracoabdominal aortic surgery. Eur J Cardiothorac Surg. 2001; 19(2):203-13. DOI: 10.1016/s1010-7940(00)00646-1. View

11.

Sinha A, Cheung A . Spinal cord protection and thoracic aortic surgery. Curr Opin Anaesthesiol. 2009; 23(1):95-102. DOI: 10.1097/ACO.0b013e3283348975. View

12.

Feezor R, Martin T, Hess Jr P, Daniels M, Beaver T, Klodell C . Extent of aortic coverage and incidence of spinal cord ischemia after thoracic endovascular aneurysm repair. Ann Thorac Surg. 2008; 86(6):1809-14. DOI: 10.1016/j.athoracsur.2008.09.022. View

13.

Ullery B, Wang G, Low D, Cheung A . Neurological complications of thoracic endovascular aortic repair. Semin Cardiothorac Vasc Anesth. 2011; 15(4):123-40. DOI: 10.1177/1089253211424224. View

14.

Buth J, Harris P, Hobo R, van Eps R, Cuypers P, Duijm L . Neurologic complications associated with endovascular repair of thoracic aortic pathology: Incidence and risk factors. a study from the European Collaborators on Stent/Graft Techniques for Aortic Aneurysm Repair (EUROSTAR) registry. J Vasc Surg. 2007; 46(6):1103-1110. DOI: 10.1016/j.jvs.2007.08.020. View

15.

Kwon B, Stammers A, Belanger L, Bernardo A, Chan D, Bishop C . Cerebrospinal fluid inflammatory cytokines and biomarkers of injury severity in acute human spinal cord injury. J Neurotrauma. 2009; 27(4):669-82. DOI: 10.1089/neu.2009.1080. View

16.

Brunnekreef G, Heijmen R, Gerritsen W, Schepens M, ter Beek H, van Dongen E . Measurements of cerebrospinal fluid concentrations of S100beta protein during and after thoracic endovascular stent grafting. Eur J Vasc Endovasc Surg. 2007; 34(2):169-72. DOI: 10.1016/j.ejvs.2007.01.013. View

17.

Matsuda H, Fukuda T, Iritani O, Nakazawa T, Tanaka H, Sasaki H . Spinal cord injury is not negligible after TEVAR for lower descending aorta. Eur J Vasc Endovasc Surg. 2009; 39(2):179-86. DOI: 10.1016/j.ejvs.2009.11.014. View

18.

Kahlert P, Eggebrecht H, Janosi R, Hildebrandt H, Plicht B, Tsagakis K . Silent cerebral ischemia after thoracic endovascular aortic repair: a neuroimaging study. Ann Thorac Surg. 2014; 98(1):53-8. DOI: 10.1016/j.athoracsur.2014.03.037. View