Acute Kidney Injury After Surgical Treatment of Failed Endovascular Aneurysm Repair

Overview

Journal Turk Gogus Kalp Damar Cerrahisi Derg

Specialty Cardiology & Vascular Diseases

Date 2024 Mar 28

PMID 38545357

Authors

Unal Aydin

Zihni Mert Duman

Muhammed Bayram

Emre Yasar

Ersin Kadirogullari

Ali Kemal Arslan

Sefa Eltutan

Muhammed Onur Hanedan

Affiliations

Soon will be listed here.

Abstract

Background: This study aims to report the incidence of acute kidney injury following surgical reconstruction after a failed endovascular aneurysm repair (EVAR) in patients with abdominal aortic aneurysms.

Methods: This retrospective study included 44 patients (39 males, 5 females; mean age: 70±11.3 years; range, 35 to 84 years) who underwent emergency or elective surgical reconstruction after failed EVAR between February 2015 and January 2019. Patients were divided into two groups: acute kidney injury group and no acute kidney injury group. The primary end-point of the study was to evaluate the development of acute kidney injury following surgery. The secondary end-points included the 30-day and one-year mortality rates.

Results: Surgical reconstruction of the abdominal aorta was performed electively in 29 (65.9%) patients and urgently in 15 (34.1%) patients. Acute kidney injury occurred in 12 (27.3%) patients. The interval from endovascular aneurysm repair to surgical reconstruction was statistically significantly higher in the no acute kidney injury group than in the acute kidney injury group (24.6±11.5 and 18.1±13.3 months, respectively; p=0.145). The mean abdominal aortic aneurysm diameter, neck angulation, and neck diameter were statistically significantly higher in the acute kidney injury group than in the no acute kidney injury group (p=0.001, p=0.009, and p<0.001, respectively). No statistically significant difference was observed between the acute kidney injury and no acute kidney injury groups for the overall 30-day mortality (p=0.185) and oneyear mortality (p=0.999).

Conclusion: Acute kidney injury is not uncommon after the surgical reconstruction of a failed EVAR. Aneurysm-related anatomical factors may have an impact on the development of postoperative acute kidney injury. Comprehensive surgical planning should be performed for open abdominal aortic surgery after a failed EVAR.

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