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Kidney Failure After Occlusion of Accessory Renal Arteries in Endovascular Abdominal Aneurysm Repair

  • Clinical Investigation
  • Arterial Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the incidence of acute renal failure and chronic kidney disease due to occlusion of accessory renal arteries during endovascular aneurysm repair of infrarenal abdominal aortic aneurysm.

Material and Methods

We retrospectively reviewed the course of 181 patients (mean age, 71, SD ± 9  years) who underwent EVAR of infrarenal abdominal aortic aneurysm. The renal vessel anatomy was analyzed in all pre- and postoperative CT scans. Diameter and origin of accessory renal arteries were evaluated. Renal function was determined by pre- and postoperative serum creatinine and eGFR levels. Long-term follow-up (>3 months) of patients was available in 121 cases (66.9%). Acute kidney injury and chronic kidney failure were defined according to guidelines of “Kidney Disease: Improving Global Outcomes” (KDIGO).

Results

In 65 of 181 patients (33.9%), 82 accessory renal arteries were identified preoperatively. In 19 of 181 patients (10.5%), one or more accessory renal arteries were covered and subsequently occluded by the implanted stent-graft device. Neither acute kidney injury (10.3% vs 12.5%; p = .785) nor chronic kidney disease (10.7% vs 15.38%; p = .452) was detected significantly more often in patients with covered accessory renal artery. The only significant predictor of acute kidney injury was the preoperative serum creatinine level (1.12 mg/dl vs. 0.98 mg/dl; p = .03). Significant predictors for chronic kidney disease were preoperative serum creatinine, eGFR, and impaired renal function (p < .001).

Conclusion

Coverage of accessory renal artery due to stent-graft does not lead either to temporary acute kidney injury after endovascular aneurysm repair or to chronic kidney disease.

Level of Evidence

Level II b.

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Authors and Affiliations

  1. Department of Radiology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany

    K. Maurer, N. Verloh, L. Lürken & C. Stroszczynski

  2. Centre for Clinical Studies, University Hospital Regensburg, Regensburg, Germany

    F. Zeman

  3. Department of Vascular and Endovascular Surgery, University Hospital Regensburg, Regensburg, Germany

    K. Pfister & P. M. Kasprzak

  4. Department of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, Regensburg, Germany

    C. Gnewuch

  5. Department of Clinical Radiology, Münster University Hospital, Münster, Germany

    M. Wildgruber

  6. Department of Diagnostic Radiology, University Hospital Halle, Halle (Saale), Germany

    W. A. Wohlgemuth

  7. Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany

    R. Müller-Wille

Authors
  1. K. Maurer
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  2. N. Verloh
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  3. L. Lürken
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  4. F. Zeman
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  5. C. Stroszczynski
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  6. K. Pfister
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  7. P. M. Kasprzak
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  8. C. Gnewuch
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  9. M. Wildgruber
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  10. W. A. Wohlgemuth
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  11. R. Müller-Wille
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Corresponding author

Correspondence to K. Maurer.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

Approval from the local ethics committee of the University Hospital Regensburg was obtained. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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This study has obtained IRB approval from the Local Ethics Committee of the University Hospital Regensburg, and the need for informed consent was waived.

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Maurer, K., Verloh, N., Lürken, L. et al. Kidney Failure After Occlusion of Accessory Renal Arteries in Endovascular Abdominal Aneurysm Repair. Cardiovasc Intervent Radiol 42, 1687–1694 (2019). https://doi.org/10.1007/s00270-019-02342-2

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  • DOI: https://doi.org/10.1007/s00270-019-02342-2

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