Renal arteries covered by aortic stents: clinical experience from endovascular grafting of aortic aneurysms.
OBJECTIVE
During the endovascular repair of abdominal aortic aneurysms (AAAs), effective anchoring of the stent-graft is difficult in the presence of a short infrarenal aneurysm neck. The aim of this study was to investigate renal artery patency and renal function after deployment of graft anchoring stents across the renal arteries.


METHODS
Retrospective open study.


METHODS
Twenty-five renal arteries, in 18 patients treated by endovascular exclusion of an AAA, were intentionally covered with the Gianturco Z-stent to ensure stent graft attachment.


METHODS
Renal artery patency was assessed by repeated spiral computed tomography (CT) scans and angiography. Creatinine levels, blood pressure and antihypertensive medication were recorded. Follow-up was a median 6 months (2-9).


RESULTS
All 25 stent-covered renal arteries remained patent. CT showed a small infarct in one kidney. Creatinine was 108 mumol/l (89-133) before intervention and 98 mumol/l (87-127) at follow-up. Blood pressure was 150/80 mmHg on both occasions. Antihypertensive therapy was intensified in one patient whose creatinine level remained stable and whose separate renin sampling was normal.


CONCLUSIONS
Covering the renal arteries with the Gianturco Z-stent does not seem to affect renal function within 6 months. Further follow-up is needed before suprarenal stent deployment can be advocated.
Malina
M
M
Department of Vascular and Renal Diseases, Lund University, Malmö University Hospital, Sweden.
Brunkwall
J
J
Ivancev
K
K
Lindh
M
M
Lindblad
B
B
Risberg
B
B
D000368:Aged; D000792:Angiography; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D014654:Vascular Patency