Renal stent complications and impact on renal function following standard fenestrated endovascular aneurysm repair.

Details

Serval ID
serval:BIB_129CB9A12F64
Type
Article: article from journal or magazin.
Collection
Publications
Title
Renal stent complications and impact on renal function following standard fenestrated endovascular aneurysm repair.
Journal
Annals of vascular surgery
Author(s)
Deslarzes-Dubuis C., Tran K., Colvard B.D., Lee J.T.
ISSN
1615-5947 (Electronic)
ISSN-L
0890-5096
Publication state
Published
Issued date
26/11/2020
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
To report renal outcomes including long-term patency, secondary interventions, and related renal function following fenestrated endovascular aortic repair (fEVAR).
Single center retrospective review of patients undergoing fEVAR between 2012-2018 using the Cook-ZFEN device. Renal stent complications, defined as any stenosis, occlusion, kink, renal stent related endoleak, and reinterventions were tabulated. Estimated glomerular filtration rate (GFR) was estimated using the MDRD formula.
During the study period, 114 patients underwent elective fEVAR. Of 329 total target vessels, 193 renal arteries were stented (133 Atrium iCAST, 60 Gore VBX). Technical success was achieved in 97.4% and the mean follow-up was 23.3 months. 17 renal complications occurred in 14 patients (12.3%), including 4 occlusions, 9 stenosis, 3 dislocations and 1 type 3 endoleak. All stent complications underwent endovascular reintervention with a median hospital stay of 1 day (0-10) and a technical success of 94.2%. One patient suffered renal hemorrhage that warranted embolization. Patients with occlusion were treated the day of diagnosis, and mean time from diagnosis to intervention for stenosis was 21.5 days. Estimated primary patency was 92.1 % and 81.5% at 24 and 48 months respectively. On multivariate analysis, larger native renal artery diameter was the only independent protective factor against patency loss (HR 0.23(0.09-0.59)). Secondary patency at latest follow-up was 99.4%. Mean eGFR was not significantly different at latest follow-up between patients with renal complications versus those without (43.75 vs 55.58 mL/min/1.73m <sup>2</sup> , p=.09). Comparing patients with and without renal stent complications, 81.4% and 72.7% of patients had stable or improved renal disease by CKD staging compared to baseline (P=.51).
fEVAR is a durable option for the treatment of juxtarenal aortic aneurysms and is associated with excellent secondary patency. Renal stent complications have no significant impact on renal function, but smaller native renal arteries are at higher risk of stent graft complications.
Keywords
complications, fenestrated endovascular aneurysm repair, renal function, renal stent
Pubmed
Create date
09/12/2020 15:59
Last modification date
10/12/2020 6:26
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