Does transrenal fixation of aortic endografts impair renal function?

Area of Science:

• Vascular Surgery
• Nephrology
• Radiology

Background:

• Transrenal fixation (TFX) for aortic endografts is associated with concerns regarding renal complications.
• Understanding the long-term renal effects of TFX is crucial for patient management.

Purpose of the Study:

• To evaluate the late effects of TFX on renal function and perfusion.
• To compare renal outcomes between TFX and infrarenal fixation (IFX) in patients undergoing aortic endograft repair.

Main Methods:

• Retrospective review of 130 patients with aortic endografts (1995-2002).
• Data analysis included serum creatinine and contrast-enhanced CT scans preoperatively and postoperatively (1-97 months).
• Patients were divided into TFX (n=69) and IFX (n=61) groups, with assessment for renal infarcts and renal function parameters.

Main Results:

• Both TFX and IFX groups showed a significant increase in serum creatinine and decrease in creatinine clearance over time.
• No significant differences in the changes of serum creatinine or creatinine clearance were observed between the TFX and IFX groups.
• A higher incidence of small renal infarcts was noted in the TFX group (5.8%) compared to the IFX group (1.6%), but these did not affect renal function.

Conclusions:

• Aortic endografting, regardless of fixation type, is associated with minor changes in renal function.
• Transrenal fixation (TFX) does not lead to greater renal function impairment compared to infrarenal fixation (IFX).
• Midterm data suggest TFX can be performed safely with comparable renal function outcomes to IFX.