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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Suprarenal graft fixation in endovascular abdominal aortic aneurysm repair is associated with a decrease in renal

Athanasios Saratzis1, Pantelis Sarafidis, Nikolaos Melas

  • 1Directorate of Research and Development, Russells Hall Hospital, Dudley Group of Hospitals NHS Foundation Trust, Dudley, United Kingdom. a_saratzis@yahoo.gr

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PubMed
Summary
This summary is machine-generated.

Suprarenal endograft fixation during endovascular aneurysm repair (EVAR) may negatively impact kidney function. This study found a significant drop in estimated glomerular filtration rate (eGFR) at 12 months in patients with suprarenal fixation.

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Area of Science:

  • Vascular Surgery
  • Nephrology
  • Medical Device Technology

Background:

  • Suprarenal endograft fixation is a common technique in endovascular repair of abdominal aortic aneurysms (EVAR).
  • This method aims to improve proximal endograft attachment but raises concerns regarding potential adverse effects on renal function.
  • Existing literature presents conflicting evidence on the renal impact of suprarenal fixation.

Purpose of the Study:

  • To prospectively assess the impact of suprarenal versus infrarenal endograft fixation on serum creatinine concentration and estimated glomerular filtration rate (eGFR).
  • To evaluate renal function changes 12 months after elective EVAR.

Main Methods:

  • A prospective study involving 92 patients undergoing elective EVAR, divided into suprarenal and infrarenal fixation groups.
  • Patients were matched for age, sex, smoking status, and aneurysm diameter.
  • Serum creatinine and eGFR were measured at baseline, 6 months, and 12 months post-procedure.

Main Results:

  • No device-related complications were observed in either group.
  • While serum creatinine did not differ significantly at 12 months, it increased in the suprarenal group compared to baseline (P < .001).
  • The suprarenal fixation group showed a significantly lower eGFR at 12 months compared to the infrarenal group (P = .027), with a significant decrease from baseline (P < .001).

Conclusions:

  • This study suggests that suprarenal endograft fixation in elective EVAR is associated with a decline in eGFR at 12 months.
  • This finding contrasts with some previous studies and highlights a potential renal risk associated with suprarenal fixation.
  • No patients developed end-stage renal disease or a >30% drop in eGFR.