Impact of Polar Renal Artery Coverage on Early Renal Function after Chimney Endovascular Aortic Aneurysm Repair.

PURPOSE

To evaluate impact of polar renal artery coverage on early renal function after chimney endovascular aneurysm repair (EVAR).

MATERIALS AND METHODS

Consecutive patients who underwent chimney EVAR for treatment of asymptomatic juxtarenal abdominal aortic aneurysm were retrospectively included. Estimated glomerular filtration rate (eGFR) was recorded before the intervention and at 1-, 5-, 7-, and 30-day follow-up. Patients without a polar renal artery were compared with patients with an uncovered polar renal artery and patients with a polar renal artery covered by the endograft.

RESULTS

Among 76 patients who underwent chimney EVAR, 15 (19.7%) had a polar renal artery. Four patients (5.3%) had an uncovered polar renal artery and 11 (14.5%) had a covered polar renal artery. The median polar renal artery diameter was 3.3 mm (interquartile range, 2.2-3.8 mm). Preoperative eGFR was similar between the 3 groups (65.5 mL/min/1.73 m, 61.1 mL/min/1.73 m, and 53 mL/min/1.73 m, P = .488). For the 3 groups, postoperative eGFR tended to decrease after the intervention compared with preoperative values, and this decrease reached statistical significance at 5 days and 30 days in patients without a polar renal artery. No significant difference was observed between the 3 groups at any time point. No correlation was observed between the diameter of the covered polar renal artery and eGFR changes postoperatively.

CONCLUSIONS

Polar renal artery coverage during chimney EVAR does not significantly impair early renal postoperative function, suggesting the safety of the procedure.