Renal infarction following endovascular aortic aneurysm repair: incidence and clinical consequences.
OBJECTIVE
To investigate the incidence of renal infarction following endovascular abdominal aortic aneurysm (AAA) repair, with particular emphasis on a comparison of suprarenal versus infrarenal endograft placement.


METHODS
Ninety-nine patients (92 men; average age 68 years) who had undergone endovascular AAA repair between July 1995 and July 1999 and who had at least 12 months' follow-up were studied with spiral computed tomographic scans to identify suprarenal endograft deployment and renal infarction.


RESULTS
Among the 193 renal arteries available for study, partial or complete transrenal endograft placement was found in 69 (36%). Sixteen (8.3%) renal infarctions were identified by the postoperative imaging studies. Perfusion of these kidneys was supplied by 6 (8.7%) of the 69 overstented renal arteries and 7 (5.6%) of the 124 uncovered arteries (p > 0.05). In the 3 other cases, intentional accessory renal artery occlusion by the stent-graft fabric led to frank segmental renal infarctions, which were visualized as territorial-perfusion defects affecting up to 27% of the renal volume. In the other 13 infarcted kidneys, the punctate deficits involved <10% of the parenchymal volume. Renal retention values were unaffected in 15 (94%) of 16 patients.


CONCLUSIONS
Documented renal infarctions following endovascular aortic stent-graft placement are not common and do not appear to be associated with suprarenal endograft fixation.
Krämer
Stefan C
SC
Department of Diagnostic Radiology, University Hospital of Ulm, Germany. Stefan.kraemer@medizin.uni-ulm.de
Seifarth
Harald
H
Pamler
Reinhard
R
Fleiter
Thorsten
T
Bühring
Julia
J
Sunder-Plassmann
Ludger
L
Brambs
Hans-Jürgen
HJ
Görich
Johannes
J
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011336:Probability; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D012079:Renal Circulation / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed