title: Renal Function after Fenestrated or Branched Endovascular Aortic Repair: The Early Impairment Predictive Factors.
abstract: BACKGROUND
  The purpose of this study was to define predictive factors of early renal impairment after fenestrated or branched endovascular aortic repair (FEVAR or BEVAR) for aortic aneurysm.
  
  
  METHODS
  Eighty-two patients underwent FEVAR or BEVAR for aortic aneurysm from January 2008 to December 2014. The primary end point was postoperative renal impairment on day 15 (D15). Renal impairment was defined as a 25% decrease in the glomerular filtration rate (GFR) and a GFR < 60 mL/min/1.73 m2according to the Risk Injury Failure Loss and End-Stage criteria. Univariate and multivariate analyses were used to determine variables associated with early postoperative renal impairment.
  
  
  RESULTS
  Seventy-seven of the 82 patients had a creatinine level on D15 and were included in this study, including a total of 145 target renal arteries. A preoperative GFR < 60 mL/min/1.73 m2was present in 16 (20.8%) patients. On D15, 8 (10.4%) patients had an early postoperative renal impairment and 21 (27.3%) patients had a GFR < 60 mL/min/1.73 m2. A single patient had immediate postoperative dialysis for 10 days. "Perirenal hematoma" and "preoperative renal length under 100 mm" were significantly associated with the occurrence of the renal impairment after mutual adjustment in multivariate analysis (P < 0.001 and P = 0.01). No significant association was found between preoperative renal insufficiency combining all stages or with a GFR < 60 mL/min/1.73 m2and early renal impairment after surgery (P = 0.096 and P = 0.263).
  
  
  CONCLUSIONS
  The presence of a reduced preoperative renal length and the postoperative occurrence of a perirenal hematoma are predictive factors of renal impairment on D15 for patients treated with FEVAR or BEVAR.
authors: Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de chirurgie vasculaire, Lyon, France; Université Lyon 1, Villeurbanne, France. Electronic address: meryl.favier-de-lachomette@chu-lyon.fr.
authors: Meryl Favier
authors: MF
authors: de Lachomette
authors: Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de chirurgie vasculaire, Lyon, France; Université Lyon 1, Villeurbanne, France.
authors: Nellie
authors: N
authors: Della
authors: Université Lyon 1, Villeurbanne, France; Hospices Civils de Lyon, Service de Biostatistique, Lyon, France; Université de Lyon, Lyon, France; CNRS, UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, Villeurbanne, France.
authors: Delphine
authors: D
authors: Maucort-Boulch
authors: Centre Hospitalier Universitaire de Saint-Etienne, Service de chirurgie cardio-vasculaire, Saint-Priest-en-Jarez, France.
authors: Ambroise
authors: A
authors: Duprey
authors: Centre Hospitalier Universitaire de Clermont-Ferrand, Hôpital Gabriel Montpied, Service de chirurgie vasculaire, Clermont-Ferrand, France.
authors: Eugenio
authors: E
authors: Rosset
authors: Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de chirurgie vasculaire, Lyon, France; Université Lyon 1, Villeurbanne, France.
authors: Patrick
authors: P
authors: Feugier
authors: Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de chirurgie vasculaire, Lyon, France; Université Lyon 1, Villeurbanne, France.
authors: Patrick
authors: P
authors: Lermusiaux
authors: Hospices Civils de Lyon, Service de Biostatistique, Lyon, France.
authors: Jean-Noël
authors: JN
authors: Albertini
authors: Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de chirurgie vasculaire, Lyon, France; Université Lyon 1, Villeurbanne, France.
authors: Antoine
authors: A
authors: Millon
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D005602:France; D005919:Glomerular Filtration Rate; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome