title: Morbidity and mortality associated with renal insufficiency and endovascular repair of abdominal aortic aneurysms: a 5-year experience.
abstract: To evaluate the outcome of patients with renal insufficiency undergoing endovascular repair of abdominal aortic aneurysm (AAA), data were prospectively collected between 1998 and 2003 on patients undergoing elective repair of their AAA with a stent graft. The patients were divided into 2 groups: those with serum creatinine (Crs) concentrations <1.2 (Group A) and those with Crs > or =1.2 mg/dL not requiring hemodialysis (Group B). The outcomes of the procedure for these 2 groups were compared. Different variables that existed between the 2 groups and contributed to mortality included estimated blood loss (EBL), volume of contrast used in the operating room, incidence of diabetes (DM), tobacco use, and history of myocardial infarction (MI). In total, 213 patients underwent elective repair of their AAA with use of a stent graft: 61% who had a Crs <1.2 mg/dL (Group A) and 39% who had a Crs > or =1.2 mg/dL not requiring dialysis (Group B). Among 129 patients with normal renal function there was an 18.6% complication rate and 1.6% mortality rate. Of 83 patients with renal insufficiency not on hemodialysis 30.1% (Fisher's Exact Test = 0.076) had 1 or more complications and there was a 6% (Fisher's Exact Test = 0.166) mortality rate. One patient in Group A (0.8%) progressed to hemodialysis and 5 (6%) patients in Group B progressed to end-stage renal disease requiring hemodialysis (p=0.068). A statistically significant higher proportion of the patients in Group B had a history of MI (p<0.001). There was no difference in the amount of EBL between the 2 groups, but a significantly lower amount of contrast (p<0.05) was used in patients with renal insufficiency.
authors.affiliation: Hartford Hospital/Connecticut Vascular Institute, Hartford, CT 06106, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Vasquez
authors.forename: Ohmid
authors.initials: O
authors.lastname: Rahmani
authors.forename: A Cecilia
authors.initials: AC
authors.lastname: Lorenzo
authors.forename: Lorraine
authors.initials: L
authors.lastname: Wolpert
authors.forename: Joseph
authors.initials: J
authors.lastname: Podolski
authors.forename: Shaun
authors.initials: S
authors.lastname: Gruenbaum
authors.forename: James J
authors.initials: JJ
authors.lastname: Gallagher
authors.forename: Phillip
authors.initials: P
authors.lastname: Allmendinger
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hallisey
authors.forename: Robert
authors.initials: R
authors.lastname: Lowe
authors.forename: Mary
authors.initials: M
authors.lastname: Windels
authors.forename: A David
authors.initials: AD
authors.lastname: Drezner
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000628:therapy; D008297:Male; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
chemical_list: D003404:Creatinine