title: Unibody endografts for abdominal aortic aneurysm repair reduce radiation and nephrotoxic exposure compared with modular endografts.
abstract: BACKGROUND
  To compare nephrotoxic and radiation exposure during elective endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms in a selected patient cohort treated with 2 different infrarenal endograft types: the unibody and modular.
  
  
  METHODS
  Procedural data were retrospectively collected in a single center, case-controlled study. From January 2010 to January 2012, patients treated with elective EVAR were analyzed. Patients treated for thoracoabdominal aneurysms, aortic dissection, aortoiliac aneurysms, and pseudoaneurysms were excluded. The remaining subjects were divided according to the endograft type: group A treated with a unibody endograft type (60 patients) and group B (57 patients) treated with a modular endograft type. Outcome measures included total procedural time, total fluoroscopy time, and volume of contrast medium.
  
  
  RESULTS
  All end points for group A and B were statistically significantly different; median surgical procedure duration was 75 vs. 105 min (P < 0.0001), median volume of iodine contrast injected was 85 vs. 170 mL (P < 0.0001), and median fluoroscopy time was 350 vs. 780 sec (P < 0.0001).
  
  
  CONCLUSIONS
  The overall EVAR procedural duration, fluoroscopy time, and volume of contrast medium infusion were significantly reduced in the group treated with the unibody endografts. These results seem to suggest that the unibody endograft may reduce patient risk of nephrotoxic action of the contrast medium, especially important in patients with existing renal insufficiency, and may reduce ionizing radiation exposure for both the patients and operators.
authors: Department of Vascular Surgery, Nuovo Ospedale S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy.
authors: Roberto
authors: R
authors: Silingardi
authors: Department of Vascular Surgery, Nuovo Ospedale S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy.
authors: Ilaria
authors: I
authors: Azzoni
authors: Department of Anesthesia and Intensive Care, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: enrico.giuliani@unimore.it.
authors: Enrico
authors: E
authors: Giuliani
authors: Department of Vascular Surgery, Nuovo Ospedale S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy.
authors: Giuseppe
authors: G
authors: Saitta
authors: Department of Vascular Surgery, Nuovo Ospedale S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy.
authors: Stefano
authors: S
authors: Gennai
authors: Department of Vascular Surgery, Nuovo Ospedale S. Agostino Estense, University of Modena and Reggio Emilia, Modena, Italy.
authors: Gioachino
authors: G
authors: Coppi
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D001027:Aortography / Q000009:adverse effects*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D017558:Elective Surgical Procedures; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control; D061646:Operative Time; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D051437:Renal Insufficiency / Q000150:complications / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media