Left renal vein ligation in surgery for abdominal aortic aneurysm

Fox, Nicola; Taylor, R. S.

doi:10.1002/bjs.1800660619

Cited by 5 publications

(4 citation statements)

References 4 publications

(3 reference statements)

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“…Only relatively small series of patients with normal renal function have been reported, with the majority demonstrating no change in renal function, either peri-operatively or long-term. [44][45][46][47] Only the largest series (58 patients) has shown any significant effect of left renal vein ligation which was a rise in serum creatinine levels in the post-operative period which had resolved in all cases when assessed at 1 week and 1 month. 48…”

Section: Renal Haemodynamics During Aortic Surgerymentioning

confidence: 99%

The Management of Abdominal Aortic Aneurysms in Patients with Concurrent Renal Impairment

Bown

Norwood

Sayers

2005

European Journal of Vascular and Endovascular Surgery

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There is little data regarding patients with end-stage renal failure and AAA although these patients appear to have a high peri-operative mortality rate. In contrast, those with renal impairment do not have a significantly higher mortality rate than those with normal renal function, rather they have a higher risk of complications associated with surgery and may require more intensive post-operative organ system support than normal patients. Many have a transient deterioration in renal function in the immediate peri-operative period that will resolve. In the case of patients with ruptured AAA, it is not clear whether pre-operative renal impairment affects mortality.

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Section: Renal Haemodynamics During Aortic Surgerymentioning

confidence: 99%

The Management of Abdominal Aortic Aneurysms in Patients with Concurrent Renal Impairment

Bown

Norwood

Sayers

2005

European Journal of Vascular and Endovascular Surgery

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“…Although there have been many studies on the functional changes of the kidney after LRVD, we have limited information on the postoperative imaging findings and their clinical significance (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Elsharawy et al (14) reported gross morphologic changes on CT in patients who underwent LRVD during the management of aortic occlusive disease.…”

Section: Discussionmentioning

confidence: 99%

“…Accordingly, left renal vein division (LRVD) is not an uncommon surgical procedure and facilitates easy access to the aorta and the left renal artery (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

“…One of the possible consequences after LRVD is a deterioration of venous drainage from the left kidney that can lead to venous hypertension, which manifests as renal dysfunction or hematuria. A number of clinical studies have demonstrated that LRVD can be safely performed, providing favorable short-and long-term clinical data (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). However, these studies focused on clinical outcomes by showing that renal function was preserved and both postoperative morbidity and mortality were not increased (12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

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CT findings after left renal vein division during abdominal aortic surgery

et al. 2020

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Background The rationale behind left renal vein division (LRVD) is the assumption that adequate collateral draining channels will develop. Purpose To describe computed tomography (CT) findings after LRVD during aortic surgery. Material and Methods Among 61 consecutive patients who underwent LRVD during aneurysm repair or revascularization for aortic occlusive disease between January 2003 and December 2017, 51 patients (40 men, mean age 71.4 ± 8.4 years) were enrolled. Contrast-enhanced CT images were analyzed to evaluate collateral drainage, patency, left renal vein diameter, and left renal parenchymal thickness. A total of 115 radiologic reports were reviewed to check whether these findings were accurately mentioned. Results The median time period of the first postoperative follow-up CT was 36 days (range 7–1351 days). The gonadal vein (n = 47) was the most common collateral draining channel, followed by the retroperitoneal veins (n = 42) and adrenal vein (n = 33). Thrombosis occurred in five patients between postoperative days 7 and 17 in the remnant renal vein (n = 3), remnant renal vein plus gonadal and adrenal veins (n = 1), and gonadal vein (n = 1). There was a significant decrease in renal vein diameter (–0.48 ± 2.12 mm, P = 0.006). There was no significant difference in parenchymal thickness (−0.25 ± 1.27 mm, P = 0.193). Neither LRVD nor any associated findings were correctly stated on radiologic reports. Conclusion Postoperative contrast-enhanced CT can delineate collateral draining channels and complications following LRVD. However, these findings tend to be either missed or misinterpreted.

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