Transrenal Aortic Endograft Placement in Patients with Renal Artery Disorders

Abstract

Abstract: Endovascular repair of abdominal aortic aneurysms (AAA) is an alternative to conventional surgical aortic reconstruction. However the presence of renal artery stenosis (RAS) and/or accessory renal arteries may alter the endovascular approach in these cases.We present two cases with infrarenal aneurysms and a coexisting unilateral renal artery stenosis (first case) and accessory renal artery (second case).In both patients endovascular treatment was undertaken. In the first patient a stent was placed for the RAS and an aortic endograft with suprarenal fixation for the aneurysm. In the second patient the placement of an aortic endograft with suprarenal fixation occluded the accessory renal artery.In the first patient renal function was normal pre- and post-intervention. In the second patient, renal function was normal pre-intervention but showed a slight deterioration postoperatively, returning to normal after 10 days. Both patients were normotensive pre- and post-intervention.In conclusion, RAS and AAA may be treated by the placement of a stent and a stent-graft simultaneously. During endovascular repair of AAA, a significant accessory renal artery (around 3mm in diameter) may safely be excluded in patients with otherwise normal renal function.