Aortic aneurysms, inflammatory pathways and nitric oxide.

The Leicester experience of treatment of aortic aneurysms indicates that workload is increasing. Despite an increase in elective repairs, the number of ruptured abdominal aortic aneurysms is also increasing. The mortality of ruptured abdominal aortic aneurysm remains static despite advances in critical care medicine. Multi-organ failure is the commonest cause of death following ruptured abdominal aortic aneurysm and the systemic inflammatory response syndrome, ischaemia-reperfusion injury and activation of inflammatory pathways are important precursors. Organ failure, reperfusion injury and inflammatory pathway activation can be studied at a cellular and biochemical level in animal models of aortic cross-clamping. The nitric oxide response is an important component of the inflammatory response and augmentation of the NO response may protect against renal injury caused by aortic cross-clamping during aortic aneurysm repair.