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Surgery Today

, Volume 46, Issue 9, pp 1062–1067 | Cite as

A perioperative strategy for abdominal aortic aneurysm in patients with chronic renal insufficiency

  • Makoto Haga
  • Katsuyuki HoshinaEmail author
  • Kunihiro Shigematsu
  • Toshiaki Watanabe
Original Article

Abstract

Purpose

The outcomes of open surgical repair (OR) or endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) are favorable; however, pre-existing chronic renal insufficiency (CRI) is considered to be a risk factor that can affect the long-term outcome. We evaluated our surgical strategy for AAA in patients with CRI by analyzing their pre- and postoperative renal function.

Methods

We conducted a retrospective chart review of CRI patients who underwent OR (n = 28) or EVAR (n = 31) for infra-renal AAA in our institution between 2009 and 2013. Our operative strategy included pre- and postoperative adequate hydration, postoperative diuretics and low-dose dopamine for both groups, intravascular ultrasonography and carbon dioxide angiography to reduce the amount of contrast media needed in the EVAR group, and occasional intraoperative mannitol for the OR group.

Results

The preoperative estimated glomerular filtration rate (eGFR) increased significantly in the postoperative period and remained similar 6 months later in both groups, without any difference in changes between the groups. In-hospital postoperative complications included leg occlusion in one EVAR patient. There were no complication-related deaths in either group.

Conclusions

Postoperative renal function was similar after the two approaches, indicating that both procedures could be performed safely using our strategy for patients with CRI.

Keywords

Abdominal aortic aneurysm Renal insufficiency Open surgical repair Endovascular aneurysm repair 

Notes

Compliance with ethical standards

Conflict of interest

We have no conflicts of interest to declare.

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Copyright information

© Springer Japan 2015

Authors and Affiliations

  • Makoto Haga
    • 1
  • Katsuyuki Hoshina
    • 1
    Email author
  • Kunihiro Shigematsu
    • 1
  • Toshiaki Watanabe
    • 1
  1. 1.Division of Vascular Surgery, Department of SurgeryThe University of TokyoTokyoJapan

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