Impact of Polar Renal Artery Coverage on Early Renal Function after Chimney Endovascular Aortic Aneurysm Repair.

Purpose: To evaluate impact of polar renal artery coverage on early renal function after chimney endovascular aneurysm repair (EVAR).

Materials And Methods: Consecutive patients who underwent chimney EVAR for treatment of asymptomatic juxtarenal abdominal aortic aneurysm were retrospectively included. Estimated glomerular filtration rate (eGFR) was recorded before the intervention and at 1-, 5-, 7-, and 30-day follow-up. Patients without a polar renal artery were compared with patients with an uncovered polar renal artery and patients with a polar renal artery covered by the endograft.

Results: Among 76 patients who underwent chimney EVAR, 15 (19.7%) had a polar renal artery. Four patients (5.3%) had an uncovered polar renal artery and 11 (14.5%) had a covered polar renal artery. The median polar renal artery diameter was 3.3 mm (interquartile range, 2.2-3.8 mm). Preoperative eGFR was similar between the 3 groups (65.5 mL/min/1.73 m, 61.1 mL/min/1.73 m, and 53 mL/min/1.73 m, P = .488). For the 3 groups, postoperative eGFR tended to decrease after the intervention compared with preoperative values, and this decrease reached statistical significance at 5 days and 30 days in patients without a polar renal artery. No significant difference was observed between the 3 groups at any time point. No correlation was observed between the diameter of the covered polar renal artery and eGFR changes postoperatively.

Conclusions: Polar renal artery coverage during chimney EVAR does not significantly impair early renal postoperative function, suggesting the safety of the procedure.