Perioperative Evaluation of MMP-9-TIMP-1 System in Vascular Surgery Regarding Ischemic-reperfusion Injury

Study Overview
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Brief Summary
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The MMP-9-TIMP-1 system has been implicated in many physiological and pathophysiological conditions including vascular surgery related ischemic-reperfusion injury. Our key aims were to establish the early perioperative time courses of the aforementioned system in aorto-bifemoral bypass and aorta stentgraft implantation procedures and to find correlation between the MMP-9-TIMP-1 system and the cross-clamp time. Patients were prospectively enrolled after Ethical Committee approval. Blood samples were taken at four different time points (T1-4): T1: right before surgery, T2: 60 min after the cross-clamp release, T3: first postoperative morning, T4: third postoperative morning. Plasma was isolated from heparin anticoagulated blood samples by low speed centrifugation at 4 °C, and stored at -80 °C until analyzed in a single batch at the end of the study. MMP- 9 and TIMP-1 were determined by the quantitative sandwich enzyme-linked immunosorbent assay (ELISA) techniques according to the manufacturer instructions (R&D Systems Inc., Minneapolis, Minnesota, USA). In comparison with standard curves, the concentrations of MMP-9 and TIMP-1 in plasma were determined spectrophotometrically (Multiskan Ascent microplate photometer, Type: 354, Thermo Electron Corporation, Waltham, Massachusetts, USA) by reading the absorbance at 450 nm. Plasma concentrations of MMP-9 and TIMP-1 were expressed as ng/ml.

Official Title
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Perioperative Evaluation of MMP-9-TIMP-1 System in Vascular Surgery Regarding Ischemic-reperfusion Injury

Conditions
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Ischemia Reperfusion Injury

Intervention / Treatment
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* Procedure: aorto-bifemoral bypass and aorta stentgraft


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Scheduled for elective procedure (aorto-bifemoral bypass or aorta stentgraft implantation) by vascular surgeons. Over age 18 agree to participate Exclusion Criteria: under age 18 refuse to participate diagnosed malignant disease chronic steroid usage being on cytostatic therapy

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Aorto-bifemoral bypass<br>Patients scheduled for elective aorto-bifemoral bypass surgery by vascular surgeons and consented to participate in the study. | Procedure: aorto-bifemoral bypass and aorta stentgraft<br>* Surgical implantation of aorto-bifemoral bypass or aorta stentgraft under general and/or regional anaesthesia.<br>|
| Aorta stentgraft<br>Patients scheduled for elective aorta stentgraft implantation by vascular surgeons and consented to participate in the study. | Procedure: aorto-bifemoral bypass and aorta stentgraft<br>* Surgical implantation of aorto-bifemoral bypass or aorta stentgraft under general and/or regional anaesthesia.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perioperative time course of the MMP-9-TIMP-1 system | To establish the early perioperative time course of MMP-9-TIMP-1 system in aorto-bifemoral bypass and aorta stentgraft implantation. | 3 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MMP-9-TIMP-1 system and ischemia-reperfusion injury | To explore relationship between MMP-9-TIMP-1 system and vascular surgery related ischemia-reperfusion injury | 3 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Matrix metalloproteinase, Tissue inhibitor of matrix metalloproteinase, Vascular surgery, Aorta stent implantation, Aorto-bifemoral bypass surgery