Viabahn Open Revascularization Technique for Renal Artery Revascularization Reduces Renal Ischemia in Thoracoabdominal Aortic Aneurysm Hybrid Open-Endovascular Repair

Abstract

To improve hybrid open-endovascular repair, the Viabahn Open Revascularization Technique (VORTEC) has emerged as a sutureless method that reduces renal ischemia time. This study aimed to compare the differences between VORTEC and standard hybrid open-endovascular repair of thoracoabdominal aortic aneurysm (TAAA) in renal ischemia. This is a retrospective analysis of 26 TAAA patients who underwent hybrid open-endovascular repair from April 2005 to April 2017. Twenty-one patients underwent standard hybrid open-endovascular repair, and 5 underwent VORTEC hybrid open-endovascular repair. Through April 2018, 26 patients were followed up for 48±43months. Nine patent renal arteries were revascularized by Viabahn in the VORTEC group, while 36 were revascularized with presewn multibranched grafts in the standard treatment group. The renal ischemia time was shorter in the VORTEC group than in the standard treatment group (5±2min vs. 15±6min). The increase in serum creatinine (SCr) on the first postoperative day in the standard treatment group was higher than that in the VORTEC group (1.68±0.79 vs. 1.14±0.05). Acute kidney injury (AKI) occurred in 5 patients in the standard treatment group (5/21, 24%). No patient experienced AKI in the VORTEC group (0/5, 0%). The renal artery (RA) patency rates in the VORTEC group were 100% (7/7) at both 1week and 12months after surgery. In the standard treatment group, the RA patency rates were 97% at 1week (33/34) and 93% at 12months (28/30) after surgery. VORTEC reduces renal ischemia time and decreases postoperative AKI in patients undergoing hybrid repair of thoracoabdominal aneurysms.