Renal arteries covered by aortic stents: clinical experience from endovascular grafting of aortic aneurysms

Eur J Vasc Endovasc Surg. 1997 Aug;14(2):109-13. doi: 10.1016/s1078-5884(97)80206-7.

Abstract

Objectives: During the endovascular repair of abdominal aortic aneurysms (AAAs), effective anchoring of the stent-graft is difficult in the presence of a short infrarenal aneurysm neck. The aim of this study was to investigate renal artery patency and renal function after deployment of graft anchoring stents across the renal arteries.

Design: Retrospective open study.

Patients: Twenty-five renal arteries, in 18 patients treated by endovascular exclusion of an AAA, were intentionally covered with the Gianturco Z-stent to ensure stent graft attachment.

Methods: Renal artery patency was assessed by repeated spiral computed tomography (CT) scans and angiography. Creatinine levels, blood pressure and antihypertensive medication were recorded. Follow-up was a median 6 months (2-9).

Results: All 25 stent-covered renal arteries remained patent. CT showed a small infarct in one kidney. Creatinine was 108 mumol/l (89-133) before intervention and 98 mumol/l (87-127) at follow-up. Blood pressure was 150/80 mmHg on both occasions. Antihypertensive therapy was intensified in one patient whose creatinine level remained stable and whose separate renin sampling was normal.

Conclusions: Covering the renal arteries with the Gianturco Z-stent does not seem to affect renal function within 6 months. Further follow-up is needed before suprarenal stent deployment can be advocated.

MeSH terms

  • Aged
  • Angiography
  • Aorta, Abdominal / diagnostic imaging
  • Aorta, Abdominal / surgery*
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / surgery*
  • Blood Vessel Prosthesis* / methods
  • Follow-Up Studies
  • Humans
  • Renal Artery / diagnostic imaging
  • Renal Artery / surgery*
  • Retrospective Studies
  • Stents*
  • Tomography, X-Ray Computed
  • Vascular Patency