Renal function changes after fenestrated endovascular aneurysm repair

Abstract

Acute and chronic renal dysfunction both occur in approximately one-quarter of patients after fEVAR; however, most of these cases are classified as mild according to consensus definitions of renal injury. The presence of mild or moderate baseline kidney disease should not preclude endovascular repair in the juxtarenal population. Routine biochemical analysis and branch vessel surveillance remain important aspects of clinical follow-up for patients undergoing fEVAR.

The ratio of contrast medium volume to estimated glomerular filtration rate as a predictor of contrast‐induced nephropathy after endovascular aortic repair

“…In addition, they concluded that increased surgical complexity was a risk factor for CIN. They suggested that minimizing surrogate markers for operative complexity is important (24). We also suggest that additional endovascular procedures should be performed in patients who have preoperative risk factors for CIN, including embolization of arteries separately from EVAR to minimize the complexity of the operation.…”

“…We strongly suspect that the increased amount of contrast medium administered in the embolization procedure was a cause of CIN development because, although the patients' characteristics and preoperative renal function did not differ significantly between the two groups, the contrast medium volume and CV/eGFR ratio were greater in patients undergoing simultaneous arterial embolization. Tran et al (24). reported that in patients who underwent fenestrated EVAR for juxtarenal or paravisceral aortic aneurysm, fluoroscopy time, operative time, and contrast volume were associated with the development of CIN.…”

Outcome of Fenestrated Endovascular Aneurysm Repair in Octogenarians: A Retrospective Multicentre Analysis

“…Special care should be taken in those with already borderline renal function. 12,23,24 A relatively higher (non-significant) number of endoleaks was seen in the octogenarian group. As higher age involves greater peri-operative risk, it is possible that the treatment of octogenarian patients was done preferably with an endovascular approach over open surgical repair, despite more challenging anatomy, consequently leading to a slightly higher number of type I endoleaks.…”

Visceral stent patency after fenestrated endovascular aneurysm repair using bare-metal stent extensions versus covered stents only

“…Previous studies have evaluated AKIs in patients undergoing FEVAR. [12][13][14][15][16] Acute and chronic kidney dysfunction appears to have occurred in approximately 25% of patients after FEVAR, but mild renal deterioration occurs in most cases. 14 The literature has described certain predictors of kidney injury after FEVAR, which include a preoperative renal length of <100 mm, prolonged operative duration, accessory renal artery thrombosis >2 mm, and occurrence of a perirenal hematoma in the postoperative period.…”

“…Acute kidney injury (AKI) was defined as an absolute increase in serum creatinine concentration of $26.4 mmol/L or a percentage increase of $50% within 48 hours of completion of the procedure. [12][13][14][15][16] We then compared whether there was any significance in AKI in patients who had a bare-metal stent extension within a renal vessel vs those who did not.…”