Suprarenal graft fixation in endovascular abdominal aortic aneurysm repair is associated with a decrease in renal function

Saratzis, Athanasios; Sarafidis, Pantelis A.; Melas, Nikolaos; Hunter, James; Saratzis, Nikolaos; Kiskinis, Dimitrios; Kitas, George D.

doi:10.1016/j.jvs.2012.01.078

Cited by 42 publications

(57 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The scope of the current analysis was not to associate EVAR-related AKI with outcome, as we have recently reported on this association(7). important observation is that EVAR can lead up to a 6 unit decrease in eGFR per annum, which is significantly more pronounced than the estimated loss of renal function compared to the general population, as we have previously shown (37). This later loss in renal function can lead to further cardiovascular morbidity over the long term.…”

Section: Discussionmentioning

confidence: 70%

See 1 more Smart Citation

Renal Function is the Main Predictor of Acute Kidney Injury after Endovascular Abdominal Aortic Aneurysm Repair

Saratzis

Nduwayo

Sarafidis

et al. 2016

Annals of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 70%

“…This has been shown to be superior to previous GFR estimates in patients with cardiovascular disease (38). We have not included serum creatinine in our multivariate analyses, as it underestimates renal dysfunction -especially in older populations with a significant cardiovascular burden, as we have previously discussed (6,29,39).…”

Section: Discussionmentioning

confidence: 98%

Renal Function is the Main Predictor of Acute Kidney Injury after Endovascular Abdominal Aortic Aneurysm Repair

Saratzis

Nduwayo

Sarafidis

et al. 2016

Annals of Vascular Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Another limitation of the study is the low number of AKIþ patients in the EVAR group, which negatively affects a statistical comparison between the two types of intervention. Finally, many potentially interesting data that have been evaluated in previous works are lacking: intensive care unit stays, 18 postoperative hemodynamic parameters, 11 intraoperative and perioperative fluid management, 19,20 contrast agent use, 5 blood losses, 5 impact of suprarenal fixation, 21 and longterm assessment of renal function. 22 A detailed report of all these parameters would have added many points of consideration to the discussion.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury after open and endovascular elective repair for infrarenal abdominal aortic aneurysms

Castagno

Varetto

Quaglino

et al. 2016

Journal of Vascular Surgery

View full text Add to dashboard Cite

Objective: The aim of this study was to evaluate the incidence of acute kidney injury (AKI) after open and endovascular abdominal aortic aneurysm repair according to the Aneurysm Renal Injury Score classification. Methods: We retrospectively evaluated 431 patients undergoing elective open aortic repair (OAR; n [ 285) or endovascular repair (n [ 146) for infrarenal aortic aneurysm. All data regarding preoperative and postoperative serum creatinine concentrations and postoperative outcomes were assessed. Univariate and multivariate logistic regression models investigated the association between AKI and different risk factors and complications. Results: The incidence of AKI was significantly higher after OAR (26.3% vs 5.5%; P < .001). A significant share of patients who experienced AKI were restored to preoperative renal function at discharge (62.5% vs 77.5% in the endovascular and OAR groups, respectively; P [ .37). Preoperative serum creatinine concentration was significantly higher in those patients who further developed AKI (1.25 vs 1.04 mg/dL; P < .001). At the multivariate analysis, AKI was significantly associated with current smoking (odds ratio [OR], 2.05; 95% confidence interval [CI], 1.19-3.52; P [ .01), hypertension (OR, 2.46; 95% CI, 1.21-4.3; P [ .01), chronic renal disease (OR, 2.53; 95% CI, 1.42-4.53; P < .001), OAR (OR, 7.3; 95% CI, 3.25-16.42; P < .001), and arrhythmias (OR, 3.16; 95% CI, 1.09-9.13; P [ .03). AKI stage did not affect postoperative outcomes, except for a longer hospital stay in patients in stage 2 and stage 3 compared with stage 1. Conclusions: AKI is a common but often reversible complication, especially after OAR. There is an urgent need of a common classification for AKI after aortic surgery. New diagnostic markers for AKI should be evaluated in large-scale studies to assess their reliability. (J Vasc Surg 2016;64:928-33.)

show abstract

“…A meta-analysis showed that 18% of patients undergoing EVAR will have a clinically significant increase in their serum creatinine (SCr) after 1 year (9). Previous studies have also demonstrated a greater decrease in eGFR for patients who undergo EVAR for the first year compared with the general population (6,10). EVAR is now offered electively in younger patients and it is therefore important to be aware of the long-term renal implications.…”

Section: Introductionmentioning

confidence: 99%

“…The latter will deviate from normal values only after at least one-half of the functioning renal mass has been affected (11). Two studies offer sufficiently long follow-up but only included a small number of patients after the first 2 years (12,13) and did not differentiate between suprarenal and infrarenal device fixation during EVAR; suprarenal fixation may adversely affect renal function (10). In addition, there are no high-quality comparisons between EVAR, OAR, and similar populations without aneurysmal disease.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Renal Function after Endovascular Aneurysm Repair

Saratzis

Bath

Harrison

et al. 2015

Clinical Journal of the American Society of Nephrology

Self Cite

View full text Add to dashboard Cite

Background and objectives Endovascular repair (EVAR) is a common treatment for abdominal aortic aneurysm (AAA). However, its long-term effects on renal function remain unclear. We aimed to assess long-term renal dysfunction after EVAR using a contemporary estimate of GFR and to compare long-term renal outcomes in patients after EVAR with open aneurysm repair (OAR) and in patients without an AAA.Design, settings, participants, & measurements We performed a nested case-matched analysis of 726 patients (using a prospectively maintained database for repairs that took place between January 2000 and May 2010 in a tertiary center): 121 patients undergoing OAR (with data at baseline and 5 years postrepair) were case matched (age, sex, smoking, diabetes, baseline eGFR) to patients undergoing suprarenal and infrarenal fixation EVAR (242 in each group) and to 121 patients undergoing carotid endarterectomy (CEA) without AAA. Changes in eGFR were compared (1 and 5 years).Results The OAR patients lost an average of 7.4 ml/min per 1.73 m 2 at 5 years (95% confidence interval [95% CI], 4.8 to 10.6), compared with 8.2 ml/min per 1.73 m 2 (95% CI, 6.5 to 10.8; P,0.001) for infrarenal-fixation EVAR, 16.9 ml/min per 1.73 m 2 (95% CI, 13.0 to 21.9, P,0.001) for suprarenal-fixation EVAR, and 5.4 ml/min per 1.73 m 2 (95% CI, 1.7 to 7.5; P,0.001) for CEA. The decrease in eGFR was steeper during the first postoperative year, with each group losing 22.2 ml/min per 1.73 m 2 (infrarenal-fixation EVAR), 210.7 ml/min per 1.73 m 2 (suprarenalfixation EVAR), and 24.6 ml/min per 1.73 m 2 (OAR), compared with 21.9 ml/min per 1.73 m 2 for CEA.Conclusions Elective EVAR is associated with a significant decline in eGFR after 5 years, which is steeper in the first postoperative year and more pronounced compared with a similar population with atherosclerotic disease.

show abstract

Suprarenal graft fixation in endovascular abdominal aortic aneurysm repair is associated with a decrease in renal function

Abstract: In contrast to previous studies, this study suggests that suprarenal endograft fixation in elective EVAR is associated with a drop in eGFR at 12 months.

Cited by 42 publications

References 36 publications

Renal Function is the Main Predictor of Acute Kidney Injury after Endovascular Abdominal Aortic Aneurysm Repair

Renal Function is the Main Predictor of Acute Kidney Injury after Endovascular Abdominal Aortic Aneurysm Repair

Acute kidney injury after open and endovascular elective repair for infrarenal abdominal aortic aneurysms

Long-Term Renal Function after Endovascular Aneurysm Repair

Contact Info

Product

Resources

About