Changes in the region and the proximal aneurysm neck after endovascular repair of infrarenal aortic aneurysms

Abstract

To analyze short and mid-term changes of the proximal aneurysm neck and to evaluate renal function after endovascular repair of infrarenal abdominal aortic aneurysms. 24 of 29 patients, who were treated endoluminally with the bifurcated Vanguard Stent graft between 1997 and 1999 underwent spiral CT follow-up after 1, 3, 6 and every 12 months. Mean follow-up period was 10.5 months (3-32 months). Follow-up included spiral CT scanning. The aortic diameter as well as cross-sectional area were measured. Stent graft position and renal perfusion were checked by spiral CT. Serum creatinine levels were determined preoperatively and during follow-up. Supra- and infrarenal aortic sizes remained stable. No correlation to the distance between the stent-graft and the renal arteries was observed. Caudal migration of the stent-graft with an average of 6.5 (3-15) mm occurred in 13 patients. Cranial migration was observed in 3 patients. Uncovered stent wires partially overlapped at least one renal artery in 18 patients. No renal infarction occurred. No significant increase of the serum creatinine level was found. The risk of proximal endoleakage due to post-interventional dilatation of the aorta abdominalis seems to be low. Insufficient stent graft fixation requires a wide distance between the proximal end of the stent graft and the aneurysm. In the mid-term uncovered stent wires overlapping the renal arteries had no relevant influence on renal function.