The juxtarenal abdominal aortic aneurysm. A more common problem than previously realized?
OBJECTIVE
To determine the incidence and treatment outcome of juxtarenal infrarenal aneurysmectomy in a vascular practice minimally biased by tertiary referral.


METHODS
A 5-year retrospective review of all aortic operations from our vascular registry was performed, and a case series of juxtarenal aneurysmectomies was analyzed.


METHODS
Of 174 infrarenal aortic aneurysmectomies performed, 27 (15.5%) (95% confidence interval, 10.5% to 21.8%) involved the juxtarenal aorta.


METHODS
Juxtarenal involvement was unsuspected but found by aortography in 25 (93%) of 27 cases. Resection was performed transabdominally in 20 cases (74%) and retroperitoneally in seven cases (26%).


METHODS
Incidence, operative technique, morbidity, and mortality were analyzed and compared with those of historical controls.


RESULTS
The incidence of juxtarenal aneurysmectomy was 15.5%. No operative deaths occurred, but there was a 19% incidence of surgical morbidity (including a 7% incidence of transient renal failure). The late survival rate was 89% (follow-up, 1 to 53 months; mean, 18 months).


CONCLUSIONS
Juxtarenal aortic aneurysms are not uncommon. Successful management is possible, even outside the large referral center.
Department of Surgical Education, Greenville Hospital System, SC.
S M
SM
Taylor
J L
JL
Mills
R M
RM
Fujitani
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D001027:Aortography; D015982:Bias; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012017:Referral and Consultation; D012077:Renal Artery; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome