[Concomitant renal revascularization and abdominal aortic aneurysm repair]

Stenosis of the renal artery is frequent in patients with atherosclerotic aortic disease.

To evaluate the surgical results of renal revascularization concomitant to the abdominal aortic aneurysm (AAA) repair.

Between April 1986 and August 2006, 783 patients were submitted to the infrarenal AAA elective repair by the first author. Of these, 24 patients (3%) were submitted to concomitant renal revascularization to the AAA repair. We analysed the demographics, surgical data and the survival through the long term results.

Sixteen patients were male (66,7%), with average age of 69,4 + 6,4 years (range, 54 to 78 years), with the majority hypertensive (62,5%) and smokers (54,2%). Nine patients (37,5%) had previous renal insufficiency (creatinine levels > 2mg/dL). Surgical indication was due to aortic aneurismatic disease in all cases. The renal procedures were unilateral in 18 patients (75%) and bilateral in 6 (25%). Occurred two deaths (8,3%) and morbidity of 25% (6/24). The mean of survival time was 53 +/- months and the estimated 5 year survival was 41,7%.

In our study, renal revascularization concomitant to AAA repair revealed acceptable mortality (8,3%), despite the high risk of our patients (previous renal dysfunction). Furthermore, the long term survival in our patients was comparable to that of patients with renal insufficiency submitted to AAA repair.