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Clinical features and significance of leukopenia occurring immediately after endovascular surgery

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Title: Clinical features and significance of leukopenia occurring immediately after endovascular surgery
Authors: Takashi, Soejima Browse this author
Kazuyuki, Mizunoya Browse this author
Yuki, Izumi Browse this author
Yokoyama, Takeshi Browse this author
Takagi, Ryo Browse this author
Morimoto, Yuji Browse this author →KAKEN DB
Keywords: Endovascular surgery
Postimplantation syndrome
Issue Date: 1-Feb-2022
Publisher: Springer
Journal Title: Journal of Anesthesia
Volume: 36
Issue: 1
Start Page: 144
End Page: 151
Publisher DOI: 10.1007/s00540-021-03020-9
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.
Rights: This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at:
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 森本 裕二

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