Renal arteries covered by aortic stents: Clinical experience from endovascular grafting of aortic aneurysms

Objectives: During the endovascular repair of abdominal aortic aneurysms (AAAs), effective anchoring of the stent-graft is difficult in the presence of a short infrarenal aneurysm neck. The aim of this study was to investigate renal artery patency and renal function after deployment of graft anchoring stents across the renal arteries. Design: Retrospective open study. Patients: Twenty-five renal arteries, in 18 patients treated by endovascular exclusion of an AAA, were intentionally covered with the Gianturco Z-stent to ensure stent graft attachment. Methods: Renal artery patency was assessed by repeated spiral computed tomography (CT) scans and angiography. Creatinine levels, blood pressure and antihypertensive medication were recorded. Follow-up was a median 6 months (2-9). Results: All 25 stent-covered renal arteries remained patent. CT showed a small infarct in one kidney. Creatinine was 108 mu mol/l (89-133) before intervention and 98 mu mol/l (87-127) at follow-up. Blood pressure was 150/80 mmHg on both occasions. antihypertensive therapy was intensified in one patient whose creatinine level remained stable and whose separate renin sampling was normal. Conclusions: Covering the renal arteries with the Gianturco Z-stent does not seem to affect renal function within 6 months. Further follow-up is needed before suprarenal stent deployment can be advocated.