Transluminal treatment of abdominal aortic aneurysms. Is there a risk of obstructing the renal arterial ostia?

During transluminal treatment of an aneurysm of the abdominal aorta, the pr oximal part of the stent may sometimes lay over the ostia of the renal arte ries. Animal studies have shown various scarring patterns depending on the type o f stent used and its duration of implantation. The Gianturco(R) and Wallste nt(R) appear to be better tolerated than the Palmaz(R) stents. The AA have shown that, with the Strecker(R) stents, a neointima developed between the meshes of the stent over a surface of 43 % +/- 30 % in 6 weeks. May and Parodi report some occlusions in their clinical series. In the AA's series using Vanguard, no renal artery was thrombosed despite the fact tha t the stent lay over the artery on 2 occasions in 105 patients. In conclusion, the consequences of the proximal part of a stent laying over the ostium of a renal artery depend mainly on the type of stent used. "Wid e mesh" stents are probably the best to use to prevent serious renal compli cations.