Abdominal aortic aneurysms: treatment with juxtarenal placement of covered stent-grafts.
OBJECTIVE
To determine the technical feasibility and clinical outcome of juxtarenal placement of covered stent-grafts for endovascular treatment of abdominal aortic aneurysms with a proximal neck less than 15 mm long.


METHODS
In seven patients, abdominal aortic aneurysms with infrarenal necks 3-14 mm long were excluded with juxtarenal implantation of polyester-nitinol coknit stent-grafts. The proximal uncovered portion of the stent-graft (length, 12 mm) was placed across one or both orifices of the renal arteries. Seven patients underwent standard infrarenal stent-graft placement. Clinical outcome in all 14 patients was determined with computed tomography (CT) and laboratory values and also with captopril renography in the patients who underwent juxtarenal placement. The mean follow-up was 10.1 months.


RESULTS
Findings from serial follow-up CT and laboratory analysis performed in all patients and captopril renography performed in five of the patients who underwent juxtarenal stent-graft placement did not reveal impaired renal function or perfusion.


CONCLUSIONS
Successful exclusion of abdominal aortic aneurysms located closer than 15 mm to the orifices of the renal arteries is possible with juxtarenal placement of the uncovered portion of the stent in the abdominal portion of the aorta.
Duda
S H
SH
Department of Radiology, Eberhard-Karls-Universität, Tübingen, Germany.
Raygrotzki
S
S
Wiskirchen
J
J
Khalighi
K
K
Schott
U
U
Bares
R
R
Ziemer
G
G
Claussen
C D
CD
D000368:Aged; D000497:Alloys; D015901:Angiography, Digital Subtraction; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D011091:Polyesters; D011474:Prosthesis Design; D011866:Radioisotope Renography; D012077:Renal Artery; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000497:Alloys; D003287:Contrast Media; D011091:Polyesters; C013616:nitinol; D007472:Iohexol; C038192:iopromide