Reply: Inflammatory Cytokine Levels After Endovascular Therapy in Patients With Peripheral Artery Disease

We evaluated the impact of endovascular therapy (EVT) on inflammatory cytokine levels and its relationship with in-stent restenosis in patients with peripheral artery disease. The study prospectively enrolled 35 patients with intermittent claudication who underwent EVT of the iliofemoral artery. Levels of interleukin 6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor (TNF-) were measured using enzyme-linked immunosorbent assay before and at 2 hours, 4 hours, and 3 months after EVT. All cytokine levels increased significantly after EVT (IL-6 [pg/mL]: from 1.51 [0.84-1.93] before EVT to 6.97 [4.05-20.41] at 2 hours and 13.29 [4.57-31.88] at 4 hours; MCP-1 [pg/mL]: from 326.65 [265.60-406.55] before EVT to 411.18 [341.21-566.27] at 2 hours and 519.36 [383.58-644.85] at 4 hours; TNF- [pg/mL]: from 1.08 [0.77-1.29] before EVT to 1.25 [0.94-1.81] at 2 hours and 1.27 [0.95-1.59] at 4 hours, all P < .001). However, cytokine levels did not differ significantly between lesions with and without in-stent restenosis. Overall, our results suggest that EVT significantly increases IL-6, MCP-1, and TNF- levels in the ischemic leg, but this effect is not associated with a higher rate of in-stent restenosis.