Kidney Failure After Occlusion of Accessory Renal Arteries in Endovascular Abdominal Aneurysm Repair

Journal Article · Sun Dec 15 04:00:00 EST 2019 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-019-02342-2· OSTI ID:22970373

Verloh, N.; Lürken, L. ^[1]; Zeman, F. ^[2]; Stroszczynski, C. ^[1]; Pfister, K.; Kasprzak, P. M. ^[3]; Gnewuch, C. ^[4]; Wildgruber, M. ^[5]; Wohlgemuth, W. A. ^[6]; Müller-Wille, R. ^[7]

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1. University Hospital Regensburg, Department of Radiology (Germany)
2. University Hospital Regensburg, Centre for Clinical Studies (Germany)
3. University Hospital Regensburg, Department of Vascular and Endovascular Surgery (Germany)
4. University Hospital Regensburg, Department of Clinical Chemistry and Laboratory Medicine (Germany)
5. Münster University Hospital, Department of Clinical Radiology (Germany)
6. University Hospital Halle, Department of Diagnostic Radiology (Germany)
7. University Medical Center Göttingen, Department of Diagnostic and Interventional Radiology (Germany)

Purpose: To evaluate the incidence of acute renal failure and chronic kidney disease due to occlusion of accessory renal arteries during endovascular aneurysm repair of infrarenal abdominal aortic aneurysm. Material and Methods: We retrospectively reviewed the course of 181 patients (mean age, 71, SD ± 9  years) who underwent EVAR of infrarenal abdominal aortic aneurysm. The renal vessel anatomy was analyzed in all pre- and postoperative CT scans. Diameter and origin of accessory renal arteries were evaluated. Renal function was determined by pre- and postoperative serum creatinine and eGFR levels. Long-term follow-up (>3 months) of patients was available in 121 cases (66.9%). Acute kidney injury and chronic kidney failure were defined according to guidelines of “Kidney Disease: Improving Global Outcomes” (KDIGO). Results: In 65 of 181 patients (33.9%), 82 accessory renal arteries were identified preoperatively. In 19 of 181 patients (10.5%), one or more accessory renal arteries were covered and subsequently occluded by the implanted stent-graft device. Neither acute kidney injury (10.3% vs 12.5%; p = .785) nor chronic kidney disease (10.7% vs 15.38%; p = .452) was detected significantly more often in patients with covered accessory renal artery. The only significant predictor of acute kidney injury was the preoperative serum creatinine level (1.12 mg/dl vs. 0.98 mg/dl; p = .03). Significant predictors for chronic kidney disease were preoperative serum creatinine, eGFR, and impaired renal function (p < .001). Conclusion: Coverage of accessory renal artery due to stent-graft does not lead either to temporary acute kidney injury after endovascular aneurysm repair or to chronic kidney disease. Level of Evidence: Level II b.

• OSTI ID: 22970373
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 12 Vol. 42; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANATOMY
ARTERIES
COMPUTERIZED TOMOGRAPHY
CREATININE
GRAFTS
INDIUM 121
INJURIES
KIDNEYS
PATIENTS
RECOMMENDATIONS
REVIEWS