title: Endovascular abdominal aortic aneurysm repair and renal complications: a comparison between suprarenal and infrarenal fixation of stent grafts.
abstract: OBJECTIVE
  This study was performed to compare the rate of morphological (renal infarction and/or ischaemic lesions) and functional renal complications after the suprarenal and infrarenal fixation of aortic stent-grafts for endovascular abdominal aortic aneurysm repair (EVAR).
  
  
  METHODS
  We retrospectively reviewed all followup computed tomography (CT) angiograms (obtained at 1, 6 and 12 months and yearly thereafter) and laboratory data pertaining to 102 patients who underwent suprarenal (60 patients, group A) or infrarenal (42 patients, group B) placement of aortic stent-grafts. The groups were compared in terms of complications affecting kidney function (creatinine clearance) and morphology (renal artery steno-occlusions, morphological and structural parenchymal changes), and pre- and postprocedural arterial pressure (AP).
  
  
  RESULTS
  Analysis of patient demographics revealed no statistically significant difference between the two groups. The proximal neck was shorter in group A (2.14 cm+/-0.84 cm) than in group B (3.41 cm+/-1.21 cm). Creatinine clearance (CrCl) decreased in both groups (group A: from 64.24 ml/min to 60.66 ml/min; group B: from 72.41 ml/min to 68.73 ml/min) without any significant difference in terms of changes in renal function (CrCl variation: -8.75% vs. -6.4%) or morphology (post-EVAR stenosis: 2.6% vs. 0%; progression of existing steno-occlusive lesions: 1% vs. 0%; ischaemic lesions: 3.2% vs. 0%), or in AP.
  
  
  CONCLUSIONS
  In our experience, the use of abdominal endografts with suprarenal fixation did not lead to any significant increase in morphological and/or functional renal complications compared with those with infrarenal fixation.
authors.affiliation: Dipartimento di Scienze Cliniche e Bioimmagini, Sezione di Scienze Radiologiche, Università degli Studi G. D'Annunzio, Ospedale SS. Annunziata, Via dei Vestini, I-66013, Chieti, Italy. ar.cotroneo@rad.unich.it
authors.forename: A R
authors.initials: AR
authors.lastname: Cotroneo
authors.forename: R
authors.initials: R
authors.lastname: Iezzi
authors.forename: D
authors.initials: D
authors.lastname: Giancristofaro
authors.forename: M
authors.initials: M
authors.lastname: Santoro
authors.forename: A
authors.initials: A
authors.lastname: Pierro
authors.forename: F
authors.initials: F
authors.lastname: Spigonardo
authors.forename: M L
authors.initials: ML
authors.lastname: Storto
mesh_terms: D000368:Aged; D000792:Angiography; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001794:Blood Pressure; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D003404:Creatinine / Q000652:urine*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology* / Q000652:urine; D008297:Male; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
chemical_list: D003404:Creatinine