Clinical impact of chronic renal insufficiency on endovascular aneurysm repair.
Endovascular aneurysm repair of abdominal aortic aneurysms has become a viable alternative to open repair. A significant proportion of this patient population has chronic renal insufficiency. The surgical outcomes associated with endovascular repair in 342 patients, with and without chronic renal insufficiency, are reported. Perioperative mortality, length of admission, length of intensive care unit admission, and rates of acute renal failure, congestive heart failure, myocardial infarction, conversion to open surgery, progression to hemodialysis, and incidence of endoleaks were retrospectively reviewed and analyzed. Endovascular repair demonstrated higher rates of acute renal failure, longer length of stay, and longer intensive care unit admissions in patients with chronic renal insufficiency. Patients with severe renal dysfunction demonstrated markedly elevated mortality and morbidity. These results indicate that chronic renal insufficiency is not an absolute contraindication to endovascular repair in patients with moderate renal dysfunction, but patients with severe renal dysfunction perform poorly after aortic reconstruction.
Park
Brian
B
Division of Vascular Surgery, Hartford Hospital, Hartford, Connecticut 06102-5037, USA.
Mavanur
Arun
A
Drezner
A David
AD
Gallagher
James
J
Menzoian
James O
JO
D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology; D000368:Aged; D017130:Angioplasty / Q000009:adverse effects; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D018579:Patient Selection; D011475:Prosthesis Failure; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology