title: Renal function after aortic stent-grafting including coverage of renal arterial ostia.
abstract: Considerable experience has been gained with endoluminal stent-graft techniques for the treatment of infrarenal aortic aneurysms. The inclusion of uncovered suprarenal stents eases the treatment of cases with a short, angulated, or bottlenecked proximal neck. However, few data have been published on the effect of a stent-graft crossing renal artery ostia on long-term renal function. We therefore retrospectively analyzed the influence of intra-aortic stent-grafts, including suprarenal fixation on long-term renal function. Thirty-nine patients who received a Gianturco Z stent across renal artery ostia as part of a made-to-measure stent-graft treating an infrarenal aortic aneurysm were evaluated at 6 (all patients) and 30 months (15 patients) after surgery. Renal function evaluation included serum creatinine level, creatinine clearance using the Cockcroft-Gault formula, and renal tomography. Initial technical success was achieved in all patients. There were no minor or major complications. Mean serum creatinine levels were 1.16 +/- 0.25, 1.12 +/- 0.28, and 1.24 +/- 0.25 mg/dL before and 6 and 30 months after endoluminal stent-graft performance, respectively (P = not significant [NS]). Mean creatinine clearances were 60.3 +/- 19.7, 63 +/- 23, and 60.6 +/- 17.5 mL/min before and 6 and 30 months after endoluminal stent-graft performance, respectively (P = NS). Only two patients (5%) had a decrease in glomerular filtration rate greater than 20% at 6 months. Both patients had renal insufficiency before endovascular grafting. Renal function was stable in all patients at 30 months' follow-up. We suggest that renal function is unaffected by coverage of renal arterial ostia with Gianturco Z stents.
authors.affiliation: Department of Nephrology, Pitié Salpétrière Hospital, Paris, France. hassan.izzedine@psl.ap-hop-paris.fr
authors.forename: Hassane
authors.initials: H
authors.lastname: Izzedine
authors.forename: Fabien
authors.initials: F
authors.lastname: Koskas
authors.forename: Philippe
authors.initials: P
authors.lastname: Cluzel
authors.forename: Alain
authors.initials: A
authors.lastname: Mallet
authors.forename: Philippe
authors.initials: P
authors.lastname: Maksud
authors.forename: Gilbert
authors.initials: G
authors.lastname: Deray
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000628:therapy; D003404:Creatinine / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000503:physiopathology*; D015607:Stents / Q000009:adverse effects*
chemical_list: D003404:Creatinine