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Clinical features and significance of leukopenia occurring immediately after endovascular surgery

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Abstract

Purpose

Inflammation after stent graft surgery is known as postimplantation syndrome (PIS) and it causes leukocytosis. However, we have experienced leukopenia in the very early postoperative phase of endovascular surgery at our institution. We investigated leukopenia, an under-recognized phenomenon that occurred after transcatheter aortic valve implantation (TAVI), endovascular aortic repair (EVAR), and thoracic endovascular aortic repair (TEVAR).

Methods

Records of patients who underwent TAVI, EVAR, and TEVAR between March 2018 and February 2019 were retrospectively reviewed. Primary outcomes were the decline rate of white blood cell count (DR-WBC) in the immediate postoperative period and its differences among surgical procedures. The secondary endpoint was the relationship between DR-WBC and infectious complications. Furthermore, the incidence of PIS and its differences among the procedures and associations with DR-WBC were evaluated.

Results

A total of 108 patients (TAVI 41, EVAR 37, TEVAR 30) were included. DR-WBC immediately after surgery was higher in the TAVI group when compared with other groups (TAVI, 43.1 ± 22.6%; EVAR, 27.6 ± 17.3%; TEVAR, 25.4 ± 27.4%; P < 0.01). DR-WBC was not significantly different regardless of postoperative infection (P = 0.45) or PIS (P = 0.62). The incidence rate of PIS was higher in the EVAR group compared with the TAVI group, and was not associated with DR-WBC.

Conclusions

Leukopenia was a common phenomenon immediately after endovascular surgery, especially TAVI. It resolved a day after surgery and was not associated with PIS or infectious complications. Therefore, it seems to be a transient abnormal hematological finding and a self-limiting condition.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

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Authors and Affiliations

  1. Department of Anesthesiology, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan

    Takashi Soejima, Kazuyuki Mizunoya & Yuji Morimoto

  2. Department of Anesthesiology, Teine Keijinkai Hospital, Sapporo, Japan

    Yuki Izumi & Takeshi Yokoyama

  3. Department of Biostatistics, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Ryo Takagi

Authors
  1. Takashi Soejima
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  2. Kazuyuki Mizunoya
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  3. Yuki Izumi
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  4. Takeshi Yokoyama
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  5. Ryo Takagi
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  6. Yuji Morimoto
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Contributions

TS contributed to design of study, data analysis, and preparation of the manuscript. KM and YM helped with drafting the manuscript. YI and TY helped with acquisition of the original data. RT helped with statistical analyses. All authors read and approved the final manuscript.

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Correspondence to Takashi Soejima.

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The authors declare no conflicts of interest associated with this manuscript.

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Soejima, T., Mizunoya, K., Izumi, Y. et al. Clinical features and significance of leukopenia occurring immediately after endovascular surgery. J Anesth 36, 144–151 (2022). https://doi.org/10.1007/s00540-021-03020-9

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  • DOI: https://doi.org/10.1007/s00540-021-03020-9

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