Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 23;14(9):864.
doi: 10.3390/diagnostics14090864.

Clinical and Radiological Outcomes of Accessory Renal Artery Exclusion during Endovascular Repair of Abdominal Aortic Aneurysms

Alessia Di Girolamo  1 , Marta Ascione  1 , Francesca Miceli  1 , Alireza Mohseni  2 , Chiara Pranteda  3 , Pasqualino Sirignano  3 , Maurizio Taurino  3 , Luca di Marzo  1 , Wassim Mansour  1
Affiliations

Clinical and Radiological Outcomes of Accessory Renal Artery Exclusion during Endovascular Repair of Abdominal Aortic Aneurysms

Alessia Di Girolamo et al. Diagnostics (Basel). .

Abstract

Background: Accessory renal arteries (ARAs) frequently coexist with abdominal aortic aneurysms (AAA) and can influence treatment. This study aimed to retrospectively analyze the ARA's exclusion effect on patients undergoing standard endovascular aneurysm repair for AAA.

Methods: The study focused on medium- and long-term outcomes, including type II endoleak, aneurysmal sac changes, mortality, reoperation rates, renal function, and infarction post-operatively.

Results: 76 patients treated with EVAR for AAA were included. One hundred and two ARAs were identified: 69 originated from the neck, 30 from the sac, and 3 from the iliac arteries. The ARA treatment was embolization in 15 patients and coverage in 72. Technical success was 100%. One-month post-operative computed tomography angiography (CTA) revealed that 76 ARAs (74.51%) were excluded. Thirty-day complications included renal deterioration in 7 patients (9.21%) and a blood pressure increase in 15 (19.73%). During follow-up, 16 patients (21.05%) died, with three aneurysm-related deaths (3.94%). ARA-related type II endoleak (T2EL) was significantly associated with the ARA's origin in the aneurysmatic sac. Despite reinterventions were not significantly linked to any factor, post-operative renal infarction was correlated with an ARA diameter greater than 3 mm and ARA embolization.

Conclusion: ARAs can influence EVAR outcomes, with anatomical and procedural factors associated with T2EL and renal infarction. Further studies are needed to optimize the management of ARAs during EVAR.

Keywords: abdominal aortic aneurysm; accessory renal artery; embolization; endovascular aneurysm repair; renal function.

PubMed Disclaimer

Conflict of interest statement

The authors did not have any conflicts of interest.

References

    1. Lareyre F., Panthier F., Jean-Baptiste E., Hassen-Khodja R., Raffort J. Coverage of Accessory Renal Arteries During Endovascular Aortic Aneurysm Repair: What Are the Consequences and the Implications for Clinical Practice? Angiology. 2019;70:12–19. doi: 10.1177/0003319718771249. - DOI - PubMed
    1. Sadeghi-Azandaryani M., Zimmermann H., Korten I., Klose A., Scheiermann P., Treitl M., Heyn J. Altered renal functions in patients with occlusion of an accessory renal artery after endovascular stenting of an infrarenal aneurysm. J. Vasc. Surg. 2017;65:635–642. doi: 10.1016/j.jvs.2016.06.116. - DOI - PubMed
    1. Saratzis A., Sarafidis P., Melas N., Khaira H. Comparison of the impact of open and endovascular abdominal aortic aneurysm repair on renal function. J. Vasc. Surg. 2014;60:597–603. doi: 10.1016/j.jvs.2014.03.282. - DOI - PubMed
    1. Pratesi C., Esposito D., Apostolou D., Attisani L., Bellosta R., Benedetto F., Blangetti I., Bonardelli S., Casini A., Fargion A.T., et al. Guidelines on the management of abdominal aortic aneurysms: Updates from the Italian Society of Vascular and Endovascular Surgery (SICVE) J. Cardiovasc. Surg. 2022;63:328–352. doi: 10.23736/S0021-9509.22.12330-X. - DOI - PubMed
    1. Chan Y.C., Qing K.X., Cheng S.W. Custom-made fenestrated stent grafts to preserve accessory renal arteries in patients with abdominal aortic aneurysms. Acta Chir. Belg. 2014;114:183–188. doi: 10.1080/00015458.2014.11681006. - DOI - PubMed

LinkOut - more resources