Renal interventions after abdominal aortic aneurysm repair using an aortic endograft with suprarenal fixation.
BACKGROUND
Our aim was to determine whether suprarenal fixation in endografts compromises renal artery (RA) flow and whether subsequent RA intervention is precluded by the stent struts.


METHODS
Prospectively acquired data from 104 patients with endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm using the Zenith endograft (Cook, Inc., Bloomington, IN) were analyzed. The Zenith device uses a 26-mm, uncovered, barbed Z stent for suprarenal function.


RESULTS
No RA stenosis, occlusion, or infarction resulted from the suprarenal stent. In 3 of 104 (2.9%) patients, RA compromise (2 stenoses, 1 occlusion) was caused by impingement of graft material on the lowermost RA. The 2 RA stenoses were stented successfully at 1 and 7 months post-EVAR. Six of 104 (5.8%) patients developed late stenoses unrelated to the endograft: all were stented successfully from 19 to 36 months after EVAR. One patient with severe RA stenosis had balloon angioplasty pre-EVAR and then was stented electively 6 weeks post-EVAR.


CONCLUSIONS
Our data show that the suprarenal fixation of the Zenith aortic endograft does not cause RA stenosis, occlusion, or infarction, nor does it preclude post-EVAR renal artery intervention.
Lalka
Stephen
S
Section of Vascular Surgery, Richard L. Roudebush Veterans Affairs Medical Center and Division of Vascular Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA. slalka@sanger-clinic.com
Johnson
Matthew
M
Namyslowski
Jan
J
Dalsing
Michael
M
Cikrit
Dolores
D
Sawchuk
Alan
A
Shafique
Shoaib
S
Nachreiner
Ryan
R
O'Brien
Elaine
E
D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D017322:Clinical Trials, Phase II as Topic; D006801:Humans; D017543:Iliac Aneurysm / Q000150:complications / Q000601:surgery*; D007238:Infarction / Q000453:epidemiology / Q000517:prevention & control*; D007668:Kidney / Q000098:blood supply*; D011183:Postoperative Complications / Q000453:epidemiology; D011474:Prosthesis Design; D012039:Regional Blood Flow; D012077:Renal Artery / Q000502:physiology*; D012078:Renal Artery Obstruction / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome