Universität zu Köln

Shahverdyan, R., Majd, M. P., Thul, R., Braun, N., Gawenda, M. and Brunkwall, J. (2015). F-EVAR does not Impair Renal Function more than Open Surgery for Juxtarenal Aortic Aneurysms: Single Centre Results. Eur. J. Vasc. Endovasc. Surg., 50 (4). S. 432 - 442. LONDON: W B SAUNDERS CO LTD. ISSN 1532-2165

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Abstract

Objective: To compare the results of elective open surgical repair (OSR) and total endovascular repair of juxtarenal aortic aneurysms (JAA), with either the Cook Zenith or the Vascutek Anaconda fenestrated stent grafts (F-EVAR) in a university hospital setting. Patients and methods: Between April 1999 and July 2014, of 926 patients with an abdominal aortic aneurysm, 69 were juxtarenal, where 34 had an elective OSR and 35 had F-EVAR. A post-operative rise of baseline creatinine by >50% and/or deterioration of estimated glomerular filtration rate by 25% were defined as renal failure. Results: The demographics of the patients were similar except for heart insufficiency, peripheral arterial disease, and pre-existing renal artery stenosis (p < .05). Median aneurysm diameters were 57 mm (range 50-80 mm) and 56 mm (range 36-64 mm) (p = .194), respectively, and the median pre-operative serum creatinine levels were 94 mu mol/L (range 65-286 mu mol/L) and 96 mu mol/L (range 57-333 mu mol/L) (p = .871) with median estimated glomerular filtration rate of 68 mL/min (range 21-117 mL/min) and 70 mL/min (range 18-114 mL/min) (p = .308) in the open and endovascular groups, respectively. The technical success (OSR versus F-EVAR) was 100% versus 94.3% with complete exclusion of the aneurysms in all cases. Median procedure time was 171 versus 188 min. During median in hospital stay of 11 versus 7 days (p = .05), mortality was 0 versus 2.9% and new onset of post-operative renal insufficiency was detected in 26.5% versus 8.5% patients (p = .05), although with 11.8% versus 5.7% being persistent (p = .428). During follow up, statistically similar new (late or persistent post-operative) renal insufficiency was detected in 14.7% versus 8.8% with dialysis in 3% of patients in each group with similar mortality within the 24 months. Conclusions: This retrospective analysis demonstrates that OSR might be combined with more acute postoperative renal impairment than F-EVAR for JAA, but with similar intermediate term procedure related mortality and renal outcomes. (C) 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Shahverdyan, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Majd, M. P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Thul, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Braun, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gawenda, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-391653
DOI:	10.1016/j.ejvs.2015.04.028
Journal or Publication Title:	Eur. J. Vasc. Endovasc. Surg.
Volume:	50
Number:	4
Page Range:	S. 432 - 442
Date:	2015
Publisher:	W B SAUNDERS CO LTD
Place of Publication:	LONDON
ISSN:	1532-2165
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OPEN REPAIR; INITIAL-EXPERIENCE; ENDOGRAFTS; OUTCOMES; OPTION; SYSTEM Multiple languages Surgery; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39165