title: Endovascular abdominal aortic aneurysm repair using the AneuRx stent graft: impact of excluding accessory renal arteries.
abstract: The aim of this study was to evaluate clinical sequelae of accessory renal artery exclusion during endo-AAA repair. Medical records and pre- and postoperative CT scans were reviewed from 114 AAA patients treated with the AneuRx stent graft between 1996-2001. Thirty-seven accessory renal arteries were identified in 32/114 patients (28%) with 19/32 patients having infrarenally located accessory renal arteries. In group I (11 patients), the stent graft excluded 11 accessory renal arteries. In group II (8 patients), eight accessory renal arteries were not excluded. Average infrarenal neck length was 24.9 mm in group I vs. 30.7 mm in group II (p = 0.07). The average length of device seal was similar in both groups (19.4 vs. 18.5 mm, p = 0.67). There were no perioperative deaths, significant postoperative hypertension, rise in serum creatinine, or postoperative renal infarctions in either group. Three of eight patients (38%) in the non-excluded group developed type I proximal endoleaks whereas none in the excluded patient group did (p = 0.06). Accessory renal arteries may be safely excluded during endovascular AAA repair and may result in a more secure proximal device fixation.
authors.affiliation: Department of Surgery, Harbor-UCLA Medical Center, Torrance 90509, CA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kim
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Donayre
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hansen
authors.forename: Ihab
authors.initials: I
authors.lastname: Aziz
authors.forename: Irwin
authors.initials: I
authors.lastname: Walot
authors.forename: Maurice
authors.initials: M
authors.lastname: Lippmann
authors.forename: George E
authors.initials: GE
authors.lastname: Kopchok
authors.forename: Rodney A
authors.initials: RA
authors.lastname: White
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome