RENAL-ARTERIES COVERED BY AORTIC STENTS - CLINICAL-EXPERIENCE FROM ENDOVASCULAR GRAFTING OF AORTIC-ANEURYSMS

Objectives: During the endovascular repair of abdominal aortic aneurys ms (AAAs), effective anchoring of the stent-graft is difficult in the presence of a short infrarenal aneurysm neck. The aim of this study wa s to investigate renal artery patency and renal function after deploym ent of graft anchoring stents across the renal arteries. Design: Retro spective open study. Patients: Twenty-five renal arteries, in 18 patie nts treated by endovascular exclusion of an AAA, were intentionally co vered with the Gianturco Z-stent to ensure stent graft attachment. Met hods: Renal artery patency was assessed by repeated spiral computed to mography (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 m u mol/l (89-133) before intervention and 98 mu mol/l (87-127) at follo w-up. Blood pressure was 150/80 mmHg on both occasions. antihypertensi ve therapy was intensified in one patient whose creatinine level remai ned stable and whose separate renin sampling was normal. Conclusions: Covering the renal arteries with the Gianturco Z-stent does not seem t o affect renal function within 6 months. Further follow-up is needed b efore suprarenal stent deployment can be advocated.