title: Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis.
abstract: OBJECTIVE
  Chronic renal insufficiency may be a relative contraindication to endovascular aneurysm repair (EVAR) for the use of contrast enhanced mediums. It is thought that more contrast enhanced media are needed in patients who are not anatomically suitable for EVAR, because of procedural difficulties. We reviewed a 2 year EVAR experience at our institution to determine whether the procedure and use of contrast enhanced mediums has any deleterious effect on renal function in patients with pre-existing chronic renal insufficiency.
  
  
  METHODS
  EVAR was performed in 46 patients with pre-existing chronic renal insufficiency without hemodialysis. Patients were retrospectively assigned to two groups on the basis of their preoperative creatinine clearance levels. Furthermore, patients were assigned to two other groups on the basis of anatomical suitability for EVAR. The absolute change in the serum creatinine (Cr) level was reviewed in the each renal insufficiency group between the preoperative and post-operative time periods.
  
  
  RESULTS
  No increase in the serum Cr level was noted, and no patient required temporary or permanent hemodialysis, in any of the groups.
  
  
  CONCLUSIONS
  EVAR with contrast agents can be accomplished in patients with chronic renal insufficiency without hemodialysis; therefore,elevated Cr levels maynot be a contraindication in EVAR.
authors.affiliation: Department of Vascular Surgery, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Guntani
authors.forename: Jyun
authors.initials: J
authors.lastname: Okadome
authors.forename: Eisuke
authors.initials: E
authors.lastname: Kawakubo
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Kyuragi
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Iwasa
authors.forename: Ryota
authors.initials: R
authors.lastname: Fukunaga
authors.forename: Sosei
authors.initials: S
authors.lastname: Kuma
authors.forename: Takuya
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Jin
authors.initials: J
authors.lastname: Okazaki
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
keywords: aneurysm; contrast enhanced medium; endovascular; renal insufficiency
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