Long-term results after accessory renal artery coverage during endovascular aortic aneurysm repair

Greenberg, Joshua I.; Dorsey, Chelsea; Dalman, Ronald L.; Lee, Jason T.; Harris, E. John; Hernandez‐Boussard, Tina; Mell, Matthew W.

doi:10.1016/j.jvs.2012.01.049

Cited by 56 publications

(62 citation statements)

References 14 publications

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“…Prior reports indicate that intentional coverage of ARAs during EVAR appears to be safe. [8][9][10][11][12] However, some of these studies have important limitations, including lack of analysis of clinical, laboratory, and anatomical data using standardized definitions, such as renal function deterioration measured using changes in estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD) stage. In addition, prior reports have not included a control group comprised of patients who had preservation of the entire kidney parenchyma during EVAR.…”

mentioning

confidence: 99%

A case-control study of intentional occlusion of accessory renal arteries during endovascular aortic aneurysm repair

Malgor

Oderich

Vrtiska

et al. 2013

Journal of Vascular Surgery

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mentioning

confidence: 99%

A case-control study of intentional occlusion of accessory renal arteries during endovascular aortic aneurysm repair

Malgor

Oderich

Vrtiska

et al. 2013

Journal of Vascular Surgery

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“…Previous studies documented that the coverage of ARAs by endografts can be well tolerated in the short-and medium-term without significant impairment of renal function or deterioration of hypertension. [5][6][7][8][9][10][11] In contrast, Greenberg et al 10 reported that postoperative renal infarction was detected in 84% of patients after EVAR with ARA coverage, and that the mean volume of the infarcted area was 12% of the total renal volume, indicating a certain degree of ischemic damage to the kidney parenchyma. Malgor et al 11 reported that coverage of ARAs larger than 3 mm in diameter during EVAR could result in type II endoleak leading to aneurysm enlargement.…”

Section: Discussionmentioning

confidence: 98%

Preservation of the accessory renal arteries after endovascular repair of common iliac artery aneurysm using kissing stent grafts

Hosaka

Miyata

Nishiyama

et al. 2016

Journal of Vascular Surgery

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Exclusion of the accessory renal arteries (ARAs) is required during endovascular aneurysm repair if they arise from the sealing zone or aneurysm sac. Here, we report a case of successful endovascular treatment for a common iliac artery aneurysm located close to the aortic bifurcation and associated with nephrotic syndrome in a 51-year-old man. The bilateral ARAs were successfully preserved using kissing stent grafts. During surgery, the proximal ends of endografts inserted from the bilateral femoral arteries were adjusted so that they met at the same level in the aorta, and simultaneous balloon dilatation was performed. This method can be a useful treatment option for common iliac aneurysms in cases with large ARAs.

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“…Greenberg et al evaluated postoperative eGFR values in EVAR-treated patients with an accessory renal artery, and compared patients in whom the accessory renal artery was occluded and patients in whom the accessory renal artery was preserved, with no significant difference observed between the two groups. 14) Occlusion of the accessory renal artery may, therefore, have no clinical significance.…”

Section: Discussionmentioning

confidence: 99%

Is Endovascular Aneurysm Repair A Relative Contraindication for Patients with Preoperative Renal Dysfunction?

et al. 2014

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Whether endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) is a relative contraindication in patients with preoperative renal dysfunction (Pre-RD), remains controversial because the contrast medium may induce nephrotoxicity. In this study 1658 patients were treated at ten Japanese medical centers between January 2005 and March 2011 (Open surgery (OS) vs. EVAR: n = 1270 vs. n = 388). They were retrospectively analyzed. Multiple logistic regression analysis (MLRA) with pre-and intra-operative variables was applied to all patients. The endpoints induced onset of new dialysis and postoperative renal dysfunction (Post-RD), were defined as a 50% decrease or more from the preoperative estimated glomerular filtration rate (eGFR) level. Results: Early mortality, Post-RD, incidence of new dialysis in all patients were 1.6% (OS: EVAR = 1.9%:0.8%), 6% (OS: EVAR = 8%:2.3%) and 1.4% (OS: EVAR = 1.5%:1.0%) respectively. MLRA identified operation time, clamp of renal artery as risk factors for Post-RD, and operation time and Pre-eGFR level as risk factors for new dialysis. Conclusion: Although Post-RD was more frequently observed in the OS group, MLRA showed that the choice of OS or EVAR was not a risk factor for Post-RD and new dialysis. It was strongly suggested that using contrast medium during EVAR is not a contraindication to AAA repair in patients with Pre-RD. (This article is a translation of J Jpn Coll Angiol 2014; 54: 13-18.)

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Long-term results after accessory renal artery coverage during endovascular aortic aneurysm repair

Cited by 56 publications

References 14 publications

A case-control study of intentional occlusion of accessory renal arteries during endovascular aortic aneurysm repair

A case-control study of intentional occlusion of accessory renal arteries during endovascular aortic aneurysm repair

Preservation of the accessory renal arteries after endovascular repair of common iliac artery aneurysm using kissing stent grafts

Is Endovascular Aneurysm Repair A Relative Contraindication for Patients with Preoperative Renal Dysfunction?

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