96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...

fibrotic neointma development as well as a reduced endothelialization
whereas in the heparin group a significant difference is not demonstrable.
All other estimated parameters did not show any differences between
controls and modified implants.
Conclusions. In the current setting the covalent binding of heparin and
heparin sulfate induce an increased rate of thrombotic events, which
counteract the original purpose of the surface modification. The morphological
changes may be interpreted as an effect of polyurethane, used
as a partner for the covalent binding of the antithrombotic materials.
FR-P-123
Individual risk assessment in AAA – the value of biomarkers and
their correlation to statin treatment
B . Mühling1 , T . Barth2 , K .-H . Orend1 1University of Ulm, Department of cardiothoracic and vascular Surgery, Ulm,
2University of Ulm, Institute of pathology, Ulm
Aims. In patients with infrarenal aortic aneurysm the aneurysm diameter
determines the indication for operative repair. An individual marker
would be interesting in order to assess the individual rupture risk or in
order to control medical treatment, e.g with statins. Hence the activity
of known metalloproteinases (MMP2/9), inflammatory cytokines (Osteoprotegerin,
Interleukin 6/10) and resistin, an adipokin, and C reactive
protein (CRP) in patients with AAA were measured and correlated to
aneurysm diameter and statin therapy.
Methods. In 63 patients with AAA from 4–9 cm with and without statin
therapy serum activity of MMP 2 and 9, Osteoprotegerin (OPG), IL-6
and IL-10, resistin and CRP levels were measured prior to aneurysm repair.
The expression pattern of resistin was also analyzed using immunohistochemistry
in tissue specimen of the aortic wall. As for age, gender
history of coronary artery disease, hypertension and smoking patient
groups were similar. The results obtained were correlated to aneurysm
diameter and statin therapy.
Results. As for CRP and IL 10 levels we found a significant correlation
to aneurysm diameter (r=0.38 and. r=0.42). IL-6, MMP 2 and 9, OPG
and resistin were not correlated. Patients under regular statin therapy
showed significantly lower levels of resistin and CRP (7.73 vs. 11.04 ng/
ml, p=0.005 resp. 1.8 vs. 6.7 mg/ml, p=0.007). Immunohistochemistry
of aneurismal tissue showed in part close co-localization of resistin and
CD 68 positive cells.
Conclusions. The investigated markers are not able to serve as biomarker
for individual risk assessment in AAA patients; however they underscore
the inflammatory nature of AAA pathogenesis. CD 68 positive cells
may mediate this inflammation. Statins have the potential to slow down
this inflammation and should be prescribed in the conservative medical
management of the disease.
FR-P-124
Risc factors for prosthetic vascular graft infection
L . Höller1 , M .K . Schilling1 , M .R . Moussavian1 1Saarland University Medical Center and Saarland University Faculty of
Medicine, Department of General, Visceral and Vascular Surgery, Homburg
Aims. Vascular prosthetic graft infections (VGI) are rare, but are associated
with a high risk of limb loss, re-infection as well as a high mortality.
Furthermore they lead to high economic costs. In this retrospective analysis
predictive factors for VGI were analyzed.
Methods. Out of a prospective SAP based database with 270 datasets,
206 patients/data sets were studied. All 206 patients were operated between
2001 and 2010 and had a re-operation within the same hospital stay.
This cohort was divided into 3 groups: A: Aortal operations B. Arteriovenous
fistulas for dialyses and C. Femoropopliteal bypasses. Patients were
studied for the primary end point infectious complications with and
without prosthetic graft infection. Infection was verified microbiologi-
cally of bacterial growth at the graft. Beside demographic data a clinical
follow-up examination photo documentation of the affected limb was
performed in all patients.
Results. In group A, neither groin incision nor drainage insertion increased
the risk for infection. However, a preoperative low hemoglobin
(12.9±0.9 vs. 10.2±0.4 95% CI 9.4–11.0 vs. 11.4–14.6; p