Results of Open Pararenal Abdominal Aortic Aneurysm Repair: Tabular Review of the Literature

Tallarita, Tiziano; Sobreira, Marcone Lima; Oderich, Gustavo S.

doi:10.1016/j.avsg.2010.10.005

Cited by 31 publications

(28 citation statements)

References 28 publications

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“…Nevertheless, these high-risk patients benefited from this total endovascular approach to achieve a 30-day survival of 92% compared with mortality rate of open repair for ruptured complex aneurysm, which has been reported as high as 40% to 80%. 3,10 The only death in this series resulted from an intracranial subarachnoid hemorrhage in a patient who had previously undergone coiling of a cerebral aneurysm. That 75% of discharged patients were able to return to their family environment directly after their hospital stay is a measure of the quality of life that was preserved in these patients postoperatively.…”

Section: Discussionmentioning

confidence: 87%

Surgeon-modified fenestrated-branched stent grafts to treat emergently ruptured and symptomatic complex aortic aneurysms in high-risk patients

Ricotta

Tsilimparis

2012

Journal of Vascular Surgery

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Sm-FBSG may play an important role in the treatment of select patients with symptomatic or ruptured complex aortic aneurysms who are at prohibitive risk for open surgery and in whom endovascular repair cannot be delayed to allow implantation of a custom-made commercial device. Until an off-the-shelf fenestrated-branched device is created that does not require a prolonged waiting period, this may be the best option to treat patients with symptomatic or ruptured complex aneurysms that are at excessively high surgical risk.

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Section: Discussionmentioning

confidence: 87%

Surgeon-modified fenestrated-branched stent grafts to treat emergently ruptured and symptomatic complex aortic aneurysms in high-risk patients

Ricotta

Tsilimparis

2012

Journal of Vascular Surgery

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“…Traditionally, these patients have been treated by open surgical repair, with an average operative mortality of 4% in the largest reports [108]. Endovascular aortic aneurysm repair (EVAR) has gained widespread acceptance for treatment of infrarenal aortic aneurysms but offers potential hazards regarding the development of renal arterial obstruction.…”

Section: Appearance Of a New Indication For Renal Artery Interventionmentioning

confidence: 99%

Percutaneous revascularization for ischemic nephropathy: the past, present, and future

Textor

Misra

Oderich

2013

Kidney International

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Occlusion of the renal arteries can threaten the viability of the kidney when severe, in addition to accelerating hypertension and circulatory congestion. Renal artery stenting procedures have evolved from a treatment mainly for renovascular hypertension to a maneuver capable of recovering threatened renal function in patients with “ischemic nephropathy” and improving management of congestive heart failure. Improved catheter design and techniques have reduced, but not eliminated hazards associated with renovascular stenting. Expanded use of endovascular stent grafts to treat abdominal aortic aneurysms has introduced a new indication for renal artery stenting to protect the renal circulation when grafts cross the origins of the renal arteries. Although controversial, prospective randomized trials to evaluate the added benefit of revascularization to current medical therapy for atherosclerotic renal artery stenosis until now have failed to identify major benefits regarding either renal function or blood pressure control. These studies have been limited by selection bias and have been harshly criticized. While studies of tissue oxygenation using blood oxygen level dependent (BOLD) MR establish that kidneys can adapt to reduced blood flow to some degree, more severe occlusive disease leads to cortical hypoxia associated with microvascular rarefication, inflammatory injury and fibrosis. Current research is directed toward identifying pathways of irreversible kidney injury due to vascular occlusion and to increase the potential for renal repair after restoring renal artery patency. The role of nephrologists likely will focus upon recognizing the limits of renal adaptation to vascular disease and identifying kidneys truly at risk for ischemic injury at a time point when renal revascularization can still be of benefit to recovering kidney function.

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“…The percentage of postoperative renal failure in Medicare rises to 10% study, although with only 0.5% needing renal replacement therapy [34]. A meta-analysis of patients undergoing elective surgery for aortic pararenal aneurysmectomy showed the presence of postoperative renal failure in 15-20% of patients, of which only 3.5% require dialysis [35]. The acute tubular necrosis secondary to renal hypoperfusion is the leading cause of acute renal failure in these patients and occurs because of the important hemodynamic changes that the aortic clamping causes to the renal blood flow, as well as hypovolemia and perioperative hypotension.…”

Section: Kidney Failurementioning

confidence: 99%

Open Repair of Pararenal Aneurysms: Renal Vessel Surgical Management

Mascia

Grandi

Porcellato

et al. 2019

Visceral Vessels and Aortic Repair

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Results of Open Pararenal Abdominal Aortic Aneurysm Repair: Tabular Review of the Literature

Cited by 31 publications

References 28 publications

Surgeon-modified fenestrated-branched stent grafts to treat emergently ruptured and symptomatic complex aortic aneurysms in high-risk patients

Surgeon-modified fenestrated-branched stent grafts to treat emergently ruptured and symptomatic complex aortic aneurysms in high-risk patients

Percutaneous revascularization for ischemic nephropathy: the past, present, and future

Open Repair of Pararenal Aneurysms: Renal Vessel Surgical Management

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