<b>Long-term Renal Function Following Endovascular Aneurysm Repair With Infrarenal and Suprarenal Aortic Stent-Grafts</b>

Alric, Pierre; Hinchliffe, Robert J.; Picot, Marie‐Christine; Braithwaite, B. D.; MacSweeney, Shane T.; Wenham, Peter W.; Hopkinson, Brian R.

doi:10.1583/1545-1550(2003)010<0397:lrffea>2.0.co;2

Cited by 49 publications

(60 citation statements)

References 32 publications

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“…243 Other smaller studies comparing renal function after EVAR or open repair have also shown a deterioration in renal function, with one study demonstrating similar decline between types of repair 244 and two others showing greater deterioration after EVAR. 245,246 Several studies have compared suprarenal versus infrarenal fixation during EVAR, and these support a deterioration in renal function after EVAR [247][248][249][250][251][252][253] but demonstrate little difference between suprarenal or infrarenal fixation. A meta-analysis of these studies provided conflicting results according to the analytical method used and concluded that the data were insufficient to draw any strong conclusions on the impact of suprarenal fixation.…”

Section: Renal Functionmentioning

confidence: 99%

The UK EndoVascular Aneurysm Repair (EVAR) trials: randomised trials of EVAR versus standard therapy.

Brown

Powell²,

Thompson³

et al. 2012

Health Technol Assess

207

170

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How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address.Paying by credit card You can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume.How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeThe Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service' . The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects...

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Section: Renal Functionmentioning

confidence: 99%

The UK EndoVascular Aneurysm Repair (EVAR) trials: randomised trials of EVAR versus standard therapy.

Brown

Powell²,

Thompson³

et al. 2012

Health Technol Assess

207

170

View full text Add to dashboard Cite

show abstract

“…Although recent studies have shown that progressive renal dysfunction may develop in patients after EVAR, data are conflicting with regard to the effects of EVAR on renal function compared with standard open repair. [8][9][10] In addition, EVAR is usually possible if patients have the appropriate anatomical morphology. It is thought that more contrast enhanced media is needed for patients who were not suitable for EVAR, because their procedures are more difficult and additional devices are used.…”

Section: Introductionmentioning

confidence: 99%

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis

Guntani

Okadome

Kawakubo

et al. 2012

Annals of Vascular Diseases

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Objective: Chronic renal insufficiency may be a relative contraindication to endovascular aneurysm repair (EVAR) for the use of contrast enhanced mediums. It is thought that more contrast enhanced media are needed in patients who are not anatomically suitable for EVAR, because of procedural difficulties. We reviewed a 2 year EVAR experience at our institution to determine whether the procedure and use of contrast enhanced mediums has any deleterious effect on renal function in patients with pre-existing chronic renal insufficiency. Materials and Methods: EVAR was performed in 46 patients with pre-existing chronic renal insufficiency without hemodialysis. Patients were retrospectively assigned to two groups on the basis of their preoperative creatinine clearance levels. Furthermore, patients were assigned to two other groups on the basis of anatomical suitability for EVAR. The absolute change in the serum creatinine (Cr) level was reviewed in the each renal insufficiency group between the preoperative and post-operative time periods. Results: No increase in the serum Cr level was noted, and no patient required temporary or permanent hemodialysis, in any of the groups. Conclusions: EVAR with contrast agents can be accomplished in patients with chronic renal insufficiency without hemodialysis; therefore,elevated Cr levels maynot be a contraindication in EVAR.

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“…However, research on the interference of stent wires with renal artery ostium or renal blood flow is scarce. While mid-and long-term results of suprarenal fixation of stent grafts seem satisfactory [7,8], the long-term safety of suprarenal stent grafts is still not fully understood. This is mainly because of the unknown effect of suprarenal stent wires on renal artery ostium from a long-term point of view.…”

Section: Discussionmentioning

confidence: 99%

“…Suprarenal fixation of stent grafts involves placing an uncovered suprarenal component above the renal arteries with aim of acquiring proximal fixation without compromising the renal blood flow or renal function. Although short to midterm results are satisfactory, long-term safety of the suprarenal fixation of stent grafts is yet to be determined [7,8].…”

Section: Introductionmentioning

confidence: 99%

Investigation of the Hemodynamic Effect of Stent Wires on Renal Arteries in Patients with Abdominal Aortic Aneurysms Treated with Suprarenal Stent-Grafts

Sun

Chaichana

2009

Cardiovasc Intervent Radiol

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Investigation of hemodynamic effect of stent wires on renal arteries in patients with abdominal aortic aneurysms treated with suprarenal stent grafts 2 Abstract Purpose: The purpose of the study was to investigate the hemodynamic effect of stent struts (wires) on renal arteries in patients with abdominal aortic aneurysms (AAA) treated with suprarenal stent grafts. Materials and Methods:Two sample patients with AAA undergoing multislice CT angiography pre-and post-suprarenal fixation of stent grafts were selected for inclusion in the study. Eight juxtarenal models focusing on the renal arteries were generated from the multislice CT datasets. Four types of configurations of stent wires crossing the renal artery ostium, namely single wire centrally crossing, single wire peripherally crossing, Vshaped wire centrally crossing and multiple wires peripherally crossing were simulated in the segmented aorta models. The blood flow pattern, flow velocity, wall pressure and wall shear stress at the renal arteries pre-and post-stent grafting were analyzed and compared using a two-way fluid structure interaction analysis. The stent wire thickness was simulated with a diameter of 0.4 mm, 1.0 mm and 2.0 mm, and hemodynamic analysis was performed at different cardiac cycles. Results:The interference of stent wires with renal blood flow was mainly determined by the thickness of stent wires, and the type of configuration of stent wires crossing the renal ostium. The flow velocity was reduced by 20-30% in most of the situations when the stent wire thickness increased to 1.0 mm and 2.0 mm. Of 4 types of configuration, the single wire crossing centrally resulted in the highest reduction of flow velocity, ranging from 21% to 28.9% among three different wire thicknesses. Wall shear stress was also dependent on the wire thickness, which decreased significantly when the wire thickness reached 1.0 and 2.0 mm.3 Conclusion: Our preliminary study showed that the hemodynamic effect of suprarenal stent wires in patients with AAA treated with suprarenal stent grafts was determined by the thickness of suprarenal stent wires. Research findings in our study are useful for follow-up of patients treated with suprarenal stent grafts to ensure long-term safety of the suprarenal fixation.

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Long-term Renal Function Following Endovascular Aneurysm Repair With Infrarenal and Suprarenal Aortic Stent-Grafts

Cited by 49 publications

References 32 publications

The UK EndoVascular Aneurysm Repair (EVAR) trials: randomised trials of EVAR versus standard therapy.

The UK EndoVascular Aneurysm Repair (EVAR) trials: randomised trials of EVAR versus standard therapy.

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis

Investigation of the Hemodynamic Effect of Stent Wires on Renal Arteries in Patients with Abdominal Aortic Aneurysms Treated with Suprarenal Stent-Grafts

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