Adjunctive renal artery revascularization during juxtarenal and suprarenal abdominal aortic aneurysm repairs

Background

We report a 15-year experience with renal artery revascularization during abdominal aortic aneurysm (AAA) repair.

Methods

AAA repairs from 1994 to 2009 were reviewed. Postoperative complications, renal function, patency, and survival in patients undergoing renal artery revascularization were evaluated and compared with a control group of patients undergoing juxtarenal AAA repairs not requiring renal artery revascularization.

Results

Sixty patients underwent renal artery revascularization during AAA repair. Transient postoperative renal insufficiency occurred in 20 patients. Temporary hemodialysis was required in 3 patients, with none requiring permanent hemodialysis. There was 1 postoperative death. There was 1 renal artery revascularization failure at 1 month but no other graft failures at 12 months median follow-up evaluation (1-year patency, 97%). In comparison with the control group, transient renal insufficiency and pulmonary complications (33.3% vs 19.8%; P = .042) were more common with renal artery revascularization, with no differences in long-term renal complications or mortality.

Conclusions

Renal artery revascularization can be performed during AAA repair with excellent patency and minimal morbidity.