Post-Intervention Immune Activation Reflects the Degree of Vascular Tissue Disruption in Minimally Invasive Limb Procedures

Abstract

This study explored whether changes in C-reactive protein (CRP) and fibrinogen levels after endovascular treatment (EVT) could reflect the extent of vascular injury caused during the procedure. A total of 71 patients undergoing EVT were analyzed, while 84 patients who had diagnostic angiography served as controls. CRP and fibrinogen levels were measured prior to the procedure and then at 8, 24, and 48 hours post-intervention. In those treated with EVT, procedural factors such as lesion classification, duration of balloon inflation, length of arterial segments treated by percutaneous transluminal angioplasty (PTA), and stent length were documented. Results showed a significant increase in CRP and fibrinogen levels 48 hours after EVT (p<0.001). No significant differences were observed across lesion complexity groups; however, CRP levels were notably higher in patients who received stents compared to those treated with PTA alone. A positive correlation was found between increases in CRP and procedural factors: the length of the PTA- treated segment (r=0.313, p=0.02), balloon inflation time (r=0.270, p=0.03), and the stented segment length (r=0.535, p=0.01). These findings suggest that inflammatory marker elevation following EV may serve as an indicator of procedural vascular trauma.