Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology.

Objective: The effect of supra-renal stent fixation during endovascular aortic aneurysm repair (EVAR) on renal function remains unclear. Using a unique validated 3D intraluminal imaging technique, we analysed the effect of suprarenal stent position relative to renal artery orifices and its medium to...

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Main Authors: O'Donnell, M., Sun, Zhonghua, Winder, J., Lau, L., Ellis, P., Blair, P.
Format: Journal Article
Published: Elsevier 2007
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/32400
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author O'Donnell, M.
Sun, Zhonghua
Winder, J.
Lau, L.
Ellis, P.
Blair, P.
author_facet O'Donnell, M.
Sun, Zhonghua
Winder, J.
Lau, L.
Ellis, P.
Blair, P.
author_sort O'Donnell, M.
building Curtin Institutional Repository
collection Online Access
description Objective: The effect of supra-renal stent fixation during endovascular aortic aneurysm repair (EVAR) on renal function remains unclear. Using a unique validated 3D intraluminal imaging technique, we analysed the effect of suprarenal stent position relative to renal artery orifices and its medium to long term effects on renal function.Methods: Thirty-four consecutive patients from a single institution were studied following EVAR using the Zenith endograft system from September 1999 to March 2002. The precise locations of the uncovered supra-renal stent struts were assessed by a virtual endoscopic imaging technique. Anatomical and quantitative categorisation of patients was made according to the configuration of uncovered stent struts across the renal artery ostia (RAO). The anatomical subgroups were defined as struts located centrally or peripherally across both RAO. The quantitative subgroups were defined as RAO crossed by multiple struts, a solitary strut or no struts. The subgroups were compared for their renal function as assessed by temporal measurements of serum creatinine concentration and creatinine clearance, and renal parenchymal perfusion defects as assessed using contrast-enhanced computerised tomography (CT).Results: Mean follow-up was 52.7 months. Separate subgroup analysis for both anatomical and quantitative configurations did not demonstrate any significant difference in renal function between the different strut permutations (p>0.05). Follow-up imaging confirmed one case of renal infarction secondary to an occluded accessory renal artery, although, this patient had normal creatinine levels.Conclusion: RAO coverage by supra-renal uncovered stents does not appear to have a significant effect on renal function as evaluated by creatinine measurements in patients with normal pre-operative renal function.
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spelling curtin-20.500.11937-324002019-02-19T05:35:39Z Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology. O'Donnell, M. Sun, Zhonghua Winder, J. Lau, L. Ellis, P. Blair, P. Virtual Intravascular Endoscopy. ascular Renal Function Virtual Intravascular Endoscopy Aortic Aneurysm EndovEndovascular Objective: The effect of supra-renal stent fixation during endovascular aortic aneurysm repair (EVAR) on renal function remains unclear. Using a unique validated 3D intraluminal imaging technique, we analysed the effect of suprarenal stent position relative to renal artery orifices and its medium to long term effects on renal function.Methods: Thirty-four consecutive patients from a single institution were studied following EVAR using the Zenith endograft system from September 1999 to March 2002. The precise locations of the uncovered supra-renal stent struts were assessed by a virtual endoscopic imaging technique. Anatomical and quantitative categorisation of patients was made according to the configuration of uncovered stent struts across the renal artery ostia (RAO). The anatomical subgroups were defined as struts located centrally or peripherally across both RAO. The quantitative subgroups were defined as RAO crossed by multiple struts, a solitary strut or no struts. The subgroups were compared for their renal function as assessed by temporal measurements of serum creatinine concentration and creatinine clearance, and renal parenchymal perfusion defects as assessed using contrast-enhanced computerised tomography (CT).Results: Mean follow-up was 52.7 months. Separate subgroup analysis for both anatomical and quantitative configurations did not demonstrate any significant difference in renal function between the different strut permutations (p>0.05). Follow-up imaging confirmed one case of renal infarction secondary to an occluded accessory renal artery, although, this patient had normal creatinine levels.Conclusion: RAO coverage by supra-renal uncovered stents does not appear to have a significant effect on renal function as evaluated by creatinine measurements in patients with normal pre-operative renal function. 2007 Journal Article http://hdl.handle.net/20.500.11937/32400 10.1016/j.jvs.2006.12.017 Elsevier fulltext
spellingShingle Virtual Intravascular Endoscopy. ascular
Renal Function
Virtual Intravascular Endoscopy
Aortic Aneurysm
EndovEndovascular
O'Donnell, M.
Sun, Zhonghua
Winder, J.
Lau, L.
Ellis, P.
Blair, P.
Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology.
title Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology.
title_full Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology.
title_fullStr Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology.
title_full_unstemmed Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology.
title_short Suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology.
title_sort suprarenal fixation of endovascular aortic stent grafts: assessment of medium-term to long-term renal function by analysis of juxtarenal stent morphology.
topic Virtual Intravascular Endoscopy. ascular
Renal Function
Virtual Intravascular Endoscopy
Aortic Aneurysm
EndovEndovascular
url http://hdl.handle.net/20.500.11937/32400