Unibody endografts for abdominal aortic aneurysm repair reduce radiation and nephrotoxic exposure compared with modular endografts

Ann Vasc Surg. 2015;29(4):751-7. doi: 10.1016/j.avsg.2014.11.011. Epub 2015 Jan 28.

Abstract

Background: To compare nephrotoxic and radiation exposure during elective endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms in a selected patient cohort treated with 2 different infrarenal endograft types: the unibody and modular.

Methods: Procedural data were retrospectively collected in a single center, case-controlled study. From January 2010 to January 2012, patients treated with elective EVAR were analyzed. Patients treated for thoracoabdominal aneurysms, aortic dissection, aortoiliac aneurysms, and pseudoaneurysms were excluded. The remaining subjects were divided according to the endograft type: group A treated with a unibody endograft type (60 patients) and group B (57 patients) treated with a modular endograft type. Outcome measures included total procedural time, total fluoroscopy time, and volume of contrast medium.

Results: All end points for group A and B were statistically significantly different; median surgical procedure duration was 75 vs. 105 min (P < 0.0001), median volume of iodine contrast injected was 85 vs. 170 mL (P < 0.0001), and median fluoroscopy time was 350 vs. 780 sec (P < 0.0001).

Conclusions: The overall EVAR procedural duration, fluoroscopy time, and volume of contrast medium infusion were significantly reduced in the group treated with the unibody endografts. These results seem to suggest that the unibody endograft may reduce patient risk of nephrotoxic action of the contrast medium, especially important in patients with existing renal insufficiency, and may reduce ionizing radiation exposure for both the patients and operators.

Publication types

  • Comparative Study

MeSH terms

  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / physiopathology
  • Acute Kidney Injury / prevention & control*
  • Aged
  • Aged, 80 and over
  • Aortic Aneurysm, Abdominal / complications
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Aortography / adverse effects*
  • Blood Vessel Prosthesis Implantation / adverse effects
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis*
  • Contrast Media / administration & dosage
  • Contrast Media / adverse effects*
  • Elective Surgical Procedures
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation*
  • Female
  • Humans
  • Kidney / physiopathology
  • Male
  • Occupational Exposure / adverse effects
  • Occupational Exposure / prevention & control
  • Operative Time
  • Predictive Value of Tests
  • Prosthesis Design
  • Radiation Dosage*
  • Radiation Injuries / etiology
  • Radiation Injuries / physiopathology
  • Radiation Injuries / prevention & control*
  • Renal Insufficiency / complications
  • Renal Insufficiency / physiopathology
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome

Substances

  • Contrast Media