Single Centre Experience in Open and Endovascular Treatment of Renal Artery Aneurysms

Laurin, Thomas; Borghese, Ottavia; Branchereau, J.; Karam, Georges; Brisard, Laurent; Corvec, Tom Le; Chaillou, Philippe; Desal, Hubert; Bourcier, Romain; Maurel, Blandine

doi:10.1016/j.avsg.2021.07.024

Cited by 9 publications

(10 citation statements)

References 25 publications

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“…Of these, 11 were comparative studies. 19,[22][23][24][25][26][27][28][29][30][31] The remaining 27 were case series, with 14 EVR, 12,[32][33][34][35][36][37][38][39][40][41][42][43][44] seven OR, 2,45-50 and six ERAT studies. [51][52][53][54][55][56] Patient numbers ranged from four to 2709, with the study by Buck et al 23 being the largest study on RAA management to date.…”

Section: Search Results and Bias Assessmentmentioning

confidence: 99%

“…Across EVR studies, we collated data on 416 aneurysms across 20 studies (Table S4). 13,22,25,26,28,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] In papers reporting aneurysm size (n = 373) 13,22,25,28,30,[31][32][33][34][35][36][37][39][40][41][42][43]44 and morphology (n = 130), 25,31,[33][34][35][36]40,42,44 the pooled mean diameter was 22.8 mm (n = 373), with 87% (n = 113) being saccular. EVR was conducted predominantly at bifurcation (56%) and proximal (34%) sites, with 10% being distal (n = 273).…”

Section: Aneurysm Morphology and Locationmentioning

confidence: 99%

“…Across OR studies, we analysed characteristics for 794 aneurysms across 16 studies (Table S5) 2,22,[24][25][26][27][28][29][30][31][45][46][47][48][49][50] The pooled mean diameter of OR aneurysms was 21.0 mm (n = 622) across papers reporting RAA size, with 79% being saccular (n = 294). In terms of aneurysm location (n = 298), 46% were at the bifurcation of the renal artery, 39% proximal, and 15% distal or intraparenchymal.…”

Section: Aneurysm Morphology and Locationmentioning

confidence: 99%

“…2a). 22,25,28,30,31 Mortality Mean length of follow up across EVR studies was 27.3 months (range: 3-108 months) (Table S6). Except for in-hospital mortality reported by Buck et al 23 (1.8%) and Hislop et al 19 (1.1%), no deaths were reported over follow up in studies reporting survival.…”

Section: Aneurysm Morphology and Locationmentioning

confidence: 99%

“…Except for in-hospital mortality reported by Buck et al 23 (1.8%) and Hislop et al 19 (1.1%), no deaths were reported over follow up in studies reporting survival. 19,[23][24][25][26][27][28][31][32][33][34][36][37][38][39][40][41][42][43]44 Mean follow-up time across OR studies was 45.9 months (range: 1-300 months) (Table S7). Survival in Tesson et al 49 and Robinson et al 48 was 100%, at 3 months and 5 years, respectively.…”

Section: Aneurysm Morphology and Locationmentioning

confidence: 99%

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Outcomes of endovascular, open surgical and autotransplantation techniques for renal artery aneurysm repair: a systematic review and meta‐analysis

Choksi

Singla

Yoon

et al. 2023

ANZ Journal of Surgery

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BackgroundRenal artery aneurysms (RAA) can be repaired with endovascular exclusion (EVR), open repair (OR), or ex‐vivo repair with renal autotransplantation (ERAT). This systematic review compares repair indications, aneurysm characteristics, and complications following these interventions.MethodsA systematic review of databases including MEDLINE, PUBMED, and EMBASE by two independent reviewers for studies from January 2000–November 2022. All studies evaluating repair indications, RAA morphology, morbidity and mortality following EVR, OR, and ERAT were included.ResultsA total of 38 studies were included with 1540 EVR, 2377 OR and 109 ERAT subjects. Increasing aneurysm size, or diameters >20 mm, were the most common repair indications across EVR and OR (n = 537; 48%), and ERAT (n = 23; 52%). All ERAT repairs were at or distal to renal artery bifurcations (n = 46). Meta‐analyses demonstrated significantly shorter length of stay (LOS) with EVR compared to OR (mean difference −4.06, 95% confidence interval (CI) −5.69 to −2.43, P < 0.001). No significant differences were found in mean aneurysm diameter (P = 0.23), total complications (P = 0.17), and mortality (P = 0.85). Major complications (Clavien‐Dindo ≥III) across studies most commonly included acute renal failure (EVR 4.9% vs. OR 7.0%). Nephrectomy was the most common major complication in ERAT (5.5%).ConclusionsOutcomes following EVR and OR of RAAs are comparable. EVR offers a shorter LOS, with no difference in morbidity or mortality. ERAT is currently only utilized for distal RAAs, however carries higher risk of infarction and nephrectomy necessitating specialized expertise or algorithms to assist appropriate selection of repair methods.

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