Effect of Percutaneous Transluminal Balloon Angioplasty on Inflammatory Biomarkers in Patients with Peripheral Arterial Disease.

BACKGROUND

Peripheral artery disease (PAD) is characterized by chronic inflammation and endothelial dysfunction. Percutaneous transluminal balloon angioplasty (PTA) restores limb perfusion, but its effects on systemic inflammatory burden are not fully defined. The objective of the study was to evaluate the effects of PTA on 30-day inflammatory biomarkers and hematological parameters in patients with lower extremity PAD.

METHODS

In this prospective observational study, 47 adults with newly diagnosed PAD (lower extremity stenosis ≥50%, ankle-brachial index [ABI] <0.90) underwent PTA. Venous blood samples were collected 1 week before and 30 days after the intervention. Plasma interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10, IL-13, transforming growth factor-beta, and tumor necrosis factor-alpha (TNF-α) were measured by sandwich enzyme-linked immunosorbent assay. C-reactive protein (CRP), procalcitonin, fibrinogen, and complete blood count were performed to calculate the neutrophil-to-lymphocyte ratio (NLR). Paired tests were used, and P < 0.05 was considered significant.

RESULTS

Proinflammatory cytokines (IL-1β, IL-2, IL-6, IL-8, and TNF-α) decreased significantly (all P < 0.001), IL-10 increased (P = 0.002) and IL-13 and transforming growth factor-beta remained unchanged. CRP and fibrinogen decreased (both P < 0.001), procalcitonin slightly increased (P = 0.018), and NLR decreased from 2.8 ± 0.9 to 2.1 ± 0.5 (P < 0.001). ΔABI was inversely correlated with ΔCRP (r = -0.334, P = 0.022) and Δfibrinogen (r = -0.315, P = 0.031). ABI improvement was greater in men, TNF-α reduction was greater in infrainguinal lesions, and IL-8 and NLR responses differed by smoking status.

CONCLUSION

PTA leads to a significant short-term improvement in limb perfusion and a concomitant reduction in systemic inflammatory burden, suggesting beneficial immunomodulatory effects beyond mechanical revascularization.