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La radiologia medica

, Volume 112, Issue 2, pp 252–263 | Cite as

Endovascular abdominal aortic aneurysm repair and renal complications: a comparison between suprarenal and infrarenal fixation of stent grafts

  • A. R. CotroneoEmail author
  • R. Iezzi
  • D. Giancristofaro
  • M. Santoro
  • A. Pierro
  • F. Spigonardo
  • M. L. Storto
VASCULAR AND INTERVENTIONAL RADIOLOGY

Abstract

Purpose.

This study was performed to compare the rate of morphological (renal infarction and/or ischaemic lesions) and functional renal complications after the suprarenal and infrarenal fixation of aortic stent-grafts for endovascular abdominal aortic aneurysm repair (EVAR).

Materials and methods.

We retrospectively reviewed all followup computed tomography (CT) angiograms (obtained at 1, 6 and 12 months and yearly thereafter) and laboratory data pertaining to 102 patients who underwent suprarenal (60 patients, group A) or infrarenal (42 patients, group B) placement of aortic stent-grafts. The groups were compared in terms of complications affecting kidney function (creatinine clearance) and morphology (renal artery steno-occlusions, morphological and structural parenchymal changes), and pre- and postprocedural arterial pressure (AP).

Results.

Analysis of patient demographics revealed no statistically significant difference between the two groups. The proximal neck was shorter in group A (2.14 cm±0.84 cm) than in group B (3.41 cm±1.21 cm). Creatinine clearance (CrCl) decreased in both groups (group A: from 64.24 ml/min to 60.66 ml/min; group B: from 72.41 ml/min to 68.73 ml/min) without any significant difference in terms of changes in renal function (CrCl variation: -8.75% vs. -6.4%) or morphology (post-EVAR stenosis: 2.6% vs. 0%; progression of existing steno-occlusive lesions: 1% vs. 0%; ischaemic lesions: 3.2% vs. 0%), or in AP.

Conclusions.

In our experience, the use of abdominal endografts with suprarenal fixation did not lead to any significant increase in morphological and/or functional renal complications compared with those with infrarenal fixation.

Key words

CT angiography Abdominal aortic aneurysm Stent graft Suprarenal fixation Renal complication 

Trattamento endovascolare degli aneurismi dell’aorta addominale e complicanze renali: confronto tra endoprotesi ad aggancio sopra e sottorenale

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Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • A. R. Cotroneo
    • 1
    Email author
  • R. Iezzi
    • 1
  • D. Giancristofaro
    • 1
  • M. Santoro
    • 1
  • A. Pierro
    • 1
  • F. Spigonardo
    • 2
  • M. L. Storto
    • 1
  1. 1.Dipartimento di Scienze Cliniche e Bioimmagini, Sezione di Scienze RadiologicheUniversità degli Studi "G. D'Annunzio", Ospedale "SS. Annunziata"ChietiItaly
  2. 2.Unità Operativa di Chirurgia Vascolare,Università degli Studi "G. D'Annunzio", Ospedale "SS. Annunziata"ChietiItaly

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