Influence of Suprarenal Stentgraft Fixation on Renal Function in Patients After Abdominal Aortic Aneurysm Endovascular Exclusion
Currently, there are two methods of stentgraft implantation considering patients with abdominal aortic aneurysms (AAA) undergoing endovascular repair: the suprarenal and infrarenal fixation. It has been suggested that suprarenal fixation may lead towards impaired kidney function.
The aim of the study was to assess the influence of suprarenal stentgraft fixation on kidney function in patients after endovascular repair of abdominal aortic aneurysms.
Material and methods. The inclusion criteria were fulfilled by 118 patients who were subjected to endovascular treatment, due to abdominal aortic aneurysms. They were consequently divided into two groups - suprarenal (NN) or infrarenal (PN) - based on the stentgraft system used. Both groups were compared on the basis of co-morbidities, operative risk (ASA score), and volume of contrast medium used intraoperatively. The creatinine concentration (cr) and creatinine clearance (Cr.cl) were assessed during the preoperative period, between the 3-rd and 7-th postoperative day, and after 3 months.
Results. Increased creatinine level during the first postoperative week was observed in 12 of 118 patients (10.1%): in the suprarenal group - 7 of 66 (10.6%), and in the infrarenal group 5 of 52 (9.96%). During the 3-rd postoperative month the increase (cr > 1.5 mg/dL) was present in 3 of 118 patients (2.5%): in the suprarenal group - 2 of 66 (3.03%) and in the infrarenal group-1 of 52 (1.9%). The difference between both groups was statistically insignificant. Furthermore, there was no statistically significant difference between creatinine clearance levels considering both groups.
Conclusions. In case of patients undergoing endovascular repair for AAA, implantation of a suprarenal device is a safe method, which does not significantly impair postoperative renal functioning. This increases the number of patients eligible for AAA treatment by means of stentgraft implantations.