Universität zu Köln

Moulakakis, K. G., Matoussevitch, V., Borgonio, A., Gawenda, M. and Brunkwall, J. (2010). Evidence that Statins Protect Renal Function During Endovascular Repair of AAAs. Eur. J. Vasc. Endovasc. Surg., 40 (5). S. 608 - 616. LONDON: W B SAUNDERS CO LTD. ISSN 1078-5884

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Abstract

Objectives: Several studies have documented a slight but significant deterioration of renal function after endovascular repair of abdominal aortic aneurysm (AAA) (EVAR). The aim of this retrospective study was therefore to investigate whether medication with statins may favourably affect perioperative renal function. Material and Methods: From January 2000 to January 2008, out of a total cohort of 287 elective patients receiving endovascular repair of their AAA or aortoiliac aneurysm, 127 patients were included in the present study, as their medication was reliably retrievable. Patients were divided according to whether their medication included statins (>3 months). Second, they were subdivided according to their supra- (SR) or infrarenal (IR) endograft fixation. Serum creatinine (SCr) and creatinine (CrCl) clearance were determined preoperatively, postoperatively, at 6 and 12 months. Patients with known pre-existing renal disease, with incorrect placement of the stent graft resulting in severe renal artery stenosis, and with occlusion or renal parenchymal infarction were excluded from the study. Results: Patients receiving an infrarenal fixation of their graft had no change in the renal function, regardless whether they were on statins or not. In patients with SR fixation not receiving statins, a deterioration in renal function was observed in the early postoperative period ((SCr) preoperative vs. SCr postoperative: 1.02 +/- 0.2 vs. 1.11 +/- 0.28, p < 0.001 and (Cr.Cl) preoperative vs. Cr.Cl postoperative: 74.1 +/- 21.4 vs. 68.0 +/- 21.4, p<0.001), whereas patients on statins experienced no change in renal function (SCr preoperative vs. SCr postoperative: 0.99 +/- 0.24 vs. 1.02 +/- 0.20 n.s. and Cr.Cl preop vs. Cr.Clpostop.: 76.4 +/- 19.1 vs. 74.28 +/- 20.50, n.s.). During follow-up, a constant worsening of renal function at 6 and 12 months was observed, irrespective of the medication with statins. Conclusions: The present study suggests a slight immediate deterioration of the renal function using (SR) fixation, and this could be prevented by the use of statins. During follow-up, statins did not protect from further renal deterioration. Broader studies are needed to confirm a definitive relation between statin use and renal protection during the endovascular repair of AAA. (C) 2010 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Moulakakis, K. G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Matoussevitch, V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Borgonio, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gawenda, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brunkwall, J. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-493279
DOI:	10.1016/j.ejvs.2010.05.006
Journal or Publication Title:	Eur. J. Vasc. Endovasc. Surg.
Volume:	40
Number:	5
Page Range:	S. 608 - 616
Date:	2010
Publisher:	W B SAUNDERS CO LTD
Place of Publication:	LONDON
ISSN:	1078-5884
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AORTIC-ANEURYSM REPAIR; VASCULAR-SURGERY; KIDNEY-DISEASE; METAANALYSIS; PROGRESSION; STENTS; ATHEROSCLEROSIS; STABILIZATION; COMPLICATIONS; ATORVASTATIN Multiple languages Surgery; Peripheral Vascular Disease Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/49327