Outcome of renal stenting for renal artery coverage during endovascular aortic aneurysm repair

Endovascular repair of infrarenal abdominal aortic aneurysms is safe, durable, and effective only when the arterial anatomy permits sealing and fixation at the attachment sites. A sufficient length of proximal aortic neck is a critical requirement for successful endovascular aneurysm repair using the current devices approved by the United States Food and Drug Administration

Jade S. Hiramoto; Catherine K. Chang; Linda M. Reilly; Darren B. Schneider; Joseph H. Rapp; Timothy A.M. Chuter

2009

Scholarcy highlights

  • Endovascular repair of infrarenal abdominal aortic aneurysms is safe, durable, and effective only when the arterial anatomy permits sealing and fixation at the attachment sites. A sufficient length of proximal aortic neck is a critical requirement for successful endovascular aneurysm repair using the current devices approved by the United States Food and Drug Administration
  • Between August 2000 and August 2008, 29 patients underwent elective endovascular abdominal aortic aneurysm repair using bifurcated Zenith stent grafts and simultaneous renal artery stenting at the University of California, San Francisco Medical Center
  • Data on medical comorbidities included the presence of diabetes mellitus, chronic obstructive pulmonary disease, hypertension, hypercholesterolemia, and cardiac disease
  • Cardiac disease was defined as any history of myocardial infarction, congestive heart failure, ischemic heart disease, or atrial fibrillation
  • The mean proximal neck length was shorter in patients who underwent the “snorkel” technique compared with those with planned endograft encroachment
  • No significant difference in neck angulation was noted among the three groups
  • Adjunctive renal artery stents can be combined with currently available, off-the-shelf stent grafts to increase the length of the proximal implantation site, allowing successful EVAR in patients who have short proximal aortic necks
  • These techniques may be used in the emergency setting or as part of a recovery maneuver when a renal artery is

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