AI Article Synopsis
Article Abstract
Background: Endovascular treatment (ER) of renal artery aneurysms (RAA) has been widely used recently due to its assumed lower morbidity and mortality compared with open surgery (OS). The purpose of this study was to investigate the outcomes of OS and ER, and compare long-term renal function.
Study Design: Data from 2000 to 2012 were retrospectively collected to identify patients who were treated for RAA in a single institution. Morbidity, mortality, freedom from reinterventions, and renal function were compared between OS and ER for RAA.
Results: Forty-four RAA repairs were identified in 40 patients (28 women, mean age ± SD 54 ± 13 years). Twenty RAA were repaired with OS (45%) and 24 RAA (55%) with ER. Mean aneurysm sizes were 2.5 ± 1.5 cm (OS) and 2.2 ± 2.2 cm (ER; p = 0.66). Endovascular repair included coil embolization with or without stent placement in 19 patients (79%) and stent grafts in 4 (17%). Open surgery included excision or aneurysmorrhaphy of the aneurysm in 11 kidneys (55%), graft interposition or bypass in 4 (20%), and 4 nephrectomies (20%). There was 1 technical failure in each group. Comorbidities were similar between the 2 groups (American Society of Anesthesiologists III-IV: OS, 40%; ER, 58%; p = 0.44). Endovascular repair and OR had equivalent perioperative morbidity (any complication OS, 15%, ER, 17%, p = 1.0) and no mortality (OS, 0%, ER, 0%). Endovascular repair was associated with shorter hospitalization (OS, 6.3 ± 2.5; ER, 2 ± 3.4 days, p < 0.001). Mean follow-ups were 21 ± 32 months (OS) and 27 ± 36 months (ER). A 30% reduction in glomerular filtration rate occurred in 12.5% of OS patients and 9.1% of ER patients (p = 1.00). Freedom from reintervention at 12 and 24 months were OS, 82%/82% and ER, 82%/74%, respectively (log-rank-test = 0.23).
Conclusions: Endovascular repair of RAA is as safe and effective as open repair in selected patients with appropriate anatomy. There was no difference in decline in renal function between OS and ER.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jamcollsurg.2013.03.021 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Thoracic endovascular aortic repair (TEVAR) in a combined penetrating thoracic aortic and spinal cord injury.
J Surg Case Rep
January 2025
Department of Trauma Surgery, University of the Witwatersrand, Floor 7, Charlotte Maxeke Johannesburg Academic Hospital, 17 Jubilee Rd, Parktown, Johannesburg, South Africa.
Endovascular repair of aortic injuries secondary to blunt trauma has been widely described. However, literature on endovascular management in penetrating aortic injuries is scarce. The patient in this case report, a victim of penetrating thoracic aortic trauma, presented 5 days after injury with Brown-Sequard syndrome and a contained aortic injury (pseudoaneurysm) and was haemodynamically stable.
View Article and Find Full Text PDFHybrid Endovascular and Direct Surgical Approach for Treatment of Penetrating Common Carotid Artery Injury: A Case Report.
NMC Case Rep J
December 2024
Department of Neurosurgery, Fukushima Medical University, Fukushima, Fukushima, Japan.
Although rare, penetrating cervical vascular injury poses significant challenges with a poor patient prognosis, often attributed to severe hemorrhage and accompanying injuries. We encountered a case of hemorrhagic shock resulting from a penetrating injury to the common carotid artery (CCA), which was successfully managed using a combination of endovascular therapy and direct surgical intervention. A 23-year-old man presented with a self-inflicted stab wound on the left side of his neck from a kitchen knife.
View Article and Find Full Text PDFFenestrated and Branched Endovascular Aortic Repair and Mortality at Hospitals Without Investigational Device Trials.
JAMA Surg
December 2024
Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University, Baltimore, Maryland.
Importance: Fenestrated and branched endovascular aortic repairs (F/BEVAR) have been adopted by many centers. However, national trends of F/BEVAR use remain unclear, particularly at sites who perform them without an US Food and Drug Adminstration (FDA)-approved investigational device exemption (IDE).
Objective: To quantify the use of F/BEVAR in the US and to determine if mortality was different at IDE vs non-IDE sites.
Case Report: Surgical treatment of type B aortic dissection in an adult with double aortic arch.
Front Cardiovasc Med
December 2024
Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Background: Double aortic arch (DAA) with type B aortic dissection in adults is a rare aortic vascular disease. The abnormal anatomical structure of the aortic arch in such patients presents significant challenges in the selection of surgical approaches, and there is a notable lack of exploration into endovascular repair approaches that simultaneously preserve asymptomatic vascular rings.
Case Description: A 43-year-old female patient was admitted due to recurrent chest and back pain lasting for over a month.
Mechanism and management of aorto-oesophageal fistulation after thoracic endovascular aortic repair.
Ann Vasc Surg
December 2024
Department of Cardiac and Vascular Surgery, University Medical Centre Mainz, Johannes Gutenberg University, Mainz, Germany.
An aorto-oesophageal fistula (AOF) is a pathological communication between the thoracic aorta and the oesophagus. It can induce life-threatening hematemesis, which is unique among the other types of gastrointestinal haemorrhage in that the vomiting is bright red and represents an arterial bleed. Nevertheless, it is notable that over 70% of cases are associated with thoracic aortic aneurysms, particularly as a postoperative complication following open surgery, and arguably more so following endovascular repair.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!