Renal Function after Fenestrated or Branched Endovascular Aortic Repair: The Early Impairment Predictive Factors

Abstract

The purpose of this study was to define predictive factors of early renal impairment after fenestrated or branched endovascular aortic repair (FEVAR or BEVAR) for aortic aneurysm. Eighty-two patients underwent FEVAR or BEVAR for aortic aneurysm from January 2008 to December 2014. The primary end point was postoperative renal impairment on day 15 (D15). Renal impairment was defined as a 25% decrease in the glomerular filtration rate (GFR) and a GFR < 60mL/min/1.73m2 according to the Risk Injury Failure Loss and End-Stage criteria. Univariate and multivariate analyses were used to determine variables associated with early postoperative renal impairment. Seventy-seven of the 82 patients had a creatinine level on D15 and were included in this study, including a total of 145 target renal arteries. A preoperative GFR < 60mL/min/1.73m2 was present in 16 (20.8%) patients. On D15, 8 (10.4%) patients had an early postoperative renal impairment and 21 (27.3%) patients had a GFR < 60mL/min/1.73m2. A single patient had immediate postoperative dialysis for 10days. "Perirenal hematoma" and "preoperative renal length under 100mm" were significantly associated with the occurrence of the renal impairment after mutual adjustment in multivariate analysis (P<0.001 and P=0.01). No significant association was found between preoperative renal insufficiency combining all stages or with a GFR < 60mL/min/1.73m2 and early renal impairment after surgery (P=0.096 and P=0.263). The presence of a reduced preoperative renal length and the postoperative occurrence of a perirenal hematoma are predictive factors of renal impairment on D15 for patients treated with FEVAR or BEVAR.