Renal function in patients treated with abdominal aortic stentgraft implantation with an intentional occlusion of accessory renal artery.

BACKGROUND

The purpose of this study was to analyze renal function in patients who underwent endovascular aneurysm repair with intentional occlusion of accessory renal artery (ARA).

MATERIAL AND METHODS

A prospective study of six patients with abdominal aortic aneurysm who underwent an abdominal stentgraft implantation with intentional occlusion of at least one ARA was performed. The mean age of the patients was 71 (53-84) years. None of the patients had an estimated glomerular filtration rate (according to Modification of Diet in Renal Disease equation 4) lower than 60 mL/min/m(2). Before the intervention, a possible influence of the occlusion of ARA was assessed with a renal scintigraphy and percentage value of a renal mass at risk. After the intervention, a control renal scintigraphy was performed, and percentage value of lost renal mass was determined. Data on the renal function before the intervention and 1, 3, 10, 30, and 90 days after the intervention were collected.

RESULTS

There were no deaths, and none of the patients required hemodialysis in the follow-up period. In an early postoperative period, five patients had pain in the lumbar region that ceased with analgesics. An increase of the serum creatinine concentration occurred between 24 and 72 hours after the procedure and, except for 1 patient, started to decrease thereafter. After 30 and 90 days, all the patients presented serum creatinine concentrations similar to the basal values. The mean value of renal mass at risk was 18.5% (13.5-26%), and the mean value of lost renal mass was 18.4% (9.6-22.5%).

CONCLUSION

The endovascular aneurysm repair with an intentional occlusion of ARA is a safe therapeutic option of treatment of abdominal aortic aneurysm in the patients without preexisting renal disease. The renal scintigraphy seems to be useful in determining loss of functional renal mass.