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Related Experiment Videos

Infrarenal aortic occlusion: does it threaten renal perfusion or function?

L M Reilly1, L Sauer, E S Weinstein

  • 1Department of Surgery, University of California, San Francisco 94143.

Journal of Vascular Surgery
|February 1, 1990
PubMed
Summary

Surgical interruption of the infrarenal aorta did not lead to suprarenal thrombus propagation. This study found no increased risk of aortic thrombus spread or significant renal complications in patients after this procedure.

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Area of Science:

  • Vascular Surgery
  • Nephrology

Background:

  • Untreated infrarenal aortic occlusion carries a risk of proximal thrombus propagation, potentially impairing renal perfusion.
  • Surgical interruption of the infrarenal aorta is a treatment for aortic graft infection.

Purpose of the Study:

  • To investigate the risk of proximal aortic thrombus propagation and its effect on renal function after surgical interruption of the infrarenal aorta.

Main Methods:

  • A cohort of 52 patients surviving 1 year or more after surgical interruption of the infrarenal aorta were studied.
  • Assessment included blood pressure, renal function (creatinine), and renal artery anatomy (angiography) before and after aortic interruption.
  • Long-term follow-up included clinical monitoring, blood pressure, renal function, and repeat aortography.

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Main Results:

  • Preoperatively, 38.4% had hypertension and 21.2% had impaired renal function. Renal artery stenosis was present in 32.6% of patients.
  • During a mean follow-up of 39.2 months, no instances of suprarenal aortic thrombus propagation were observed on follow-up aortography.
  • Most patients (78.8%) maintained stable blood pressure and renal function; 13.5% developed worsening hypertension or rising creatinine.

Conclusions:

  • Surgical interruption of the infrarenal aorta in the context of aortic graft infection does not appear to cause proximal thrombus propagation.
  • Renal function and blood pressure remain stable in the majority of patients following this intervention.
  • The study suggests that the feared complication of suprarenal thrombus propagation is not a significant risk after infrarenal aortic interruption.