title: Incidence and Clinical Significance of Renal Infarct After Fenestrated Endovascular Aortic Aneurysm Repair.
abstract: OBJECTIVE
  The purpose of this study is to determine the incidence and clinical significance of renal infarcts after fenestrated endovascular aortic aneurysm repair (FEVAR).
  
  
  METHODS
  All patients who underwent FEVAR with unenhanced and contrast-enhanced CT angiography during a 4-year period were retrospectively reviewed. Two staff radiologists reviewed pre- and post-FEVAR CT examinations for the presence of renal infarcts. Pre- and postoperative serum creatinine levels were examined to determine statistical significance. The incidence of renal infarct and percentage of renal volume reduction were calculated.
  
  
  RESULTS
  Ninety patients were included for analysis. All patients had a mild progressive increase in serum creatinine level after FEVAR. Twenty-three patients (26%) had a renal infarct identified on post-FEVAR CT, nine (39%) of which were secondary to intentional exclusion of an accessory renal artery and 14 (61%) of which were presumed to be embolic. Two patients with presumed embolic infarcts and three with exclusion of an accessory renal artery had an increase in serum creatinine level of greater than 0.3 mg/dL at 1 month after FEVAR.
  
  
  CONCLUSIONS
  Although renal infarcts are common after FEVAR, the clinical relevance of these events appears to be limited, with less than one-quarter of patients with renal infarcts experiencing a decline in renal function.
authors.affiliation: 1 Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Dr, Chapel Hill, NC 27514.
authors.forename: Lauren M B
authors.initials: LM
authors.lastname: Burke
authors.affiliation: 1 Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Dr, Chapel Hill, NC 27514.
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Conyers
authors.affiliation: 1 Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Dr, Chapel Hill, NC 27514.
authors.forename: Charles T
authors.initials: CT
authors.lastname: Burke
authors.affiliation: 1 Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Dr, Chapel Hill, NC 27514.
authors.forename: Robert
authors.initials: R
authors.lastname: Dixon
authors.affiliation: 1 Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Dr, Chapel Hill, NC 27514.
authors.forename: Hyeon
authors.initials: H
authors.lastname: Yu
authors.affiliation: 1 Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Dr, Chapel Hill, NC 27514.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Kim
authors.affiliation: 2 Department of Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: Raghuveer
authors.initials: R
authors.lastname: Vallabhaneni
authors.affiliation: 2 Department of Surgery, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Farber
authors.affiliation: 1 Department of Radiology, University of North Carolina at Chapel Hill School of Medicine, 101 Manning Dr, Chapel Hill, NC 27514.
authors.forename: Ari J
authors.initials: AJ
authors.lastname: Isaacson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D015984:Causality; D000072226:Computed Tomography Angiography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007238:Infarction / Q000453:epidemiology*; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000706:statistics & numerical data*; D009657:North Carolina / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: CT angiography; fenestrated endovascular aortic aneurysm repair; renal infarct