Daniel Silverberg1, Tal Yalon, Moshe Halak. 1. The Department of Vascular Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel, silverberg_d@msn.com.
Abstract
PURPOSE: To present our experience performing endovascular repair of abdominal aortic aneurysms in kidney transplanted patients. METHODS: A retrospective review of all patients who underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA) performed at our institution from 2007 to 2014. We identified all patients who had previously undergone a kidney transplant. Data collected included: comorbidities, preoperative imaging modalities, indication for surgery, stent graft configurations, pre- and postoperative renal function, perioperative complications, and survival rates. RESULTS: A total of 267 EVARs were performed. Six (2%) had a transplanted kidney. Mean age was 74 (range, 64-82) years; five were males. Mean time from transplantation to EVAR was 7.5 (range, 2-12) years. Five underwent preoperative planning with noncontrast modalities only. Devices used included bifurcated (n = 3), aortouniiliac (n = 2), and tube (n = 1) stent grafts. Technical success was achieved in all patients. None experienced deterioration in renal function. Median follow-up was 39 (range, 6-51) months. Four patients were alive at the time of the study. Two patients expired during the period of follow-up from unrelated causes. CONCLUSIONS: EVAR is an effective modality for the management of AAAs in the coexistence of a transplanted kidney. It can be performed with minimal morbidity and mortality without harming the transplanted kidney. Special consideration should be given to device configuration to minimize damage to the renal graft.
PURPOSE: To present our experience performing endovascular repair of abdominal aortic aneurysms in kidney transplanted patients. METHODS: A retrospective review of all patients who underwent endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA) performed at our institution from 2007 to 2014. We identified all patients who had previously undergone a kidney transplant. Data collected included: comorbidities, preoperative imaging modalities, indication for surgery, stent graft configurations, pre- and postoperative renal function, perioperative complications, and survival rates. RESULTS: A total of 267 EVARs were performed. Six (2%) had a transplanted kidney. Mean age was 74 (range, 64-82) years; five were males. Mean time from transplantation to EVAR was 7.5 (range, 2-12) years. Five underwent preoperative planning with noncontrast modalities only. Devices used included bifurcated (n = 3), aortouniiliac (n = 2), and tube (n = 1) stent grafts. Technical success was achieved in all patients. None experienced deterioration in renal function. Median follow-up was 39 (range, 6-51) months. Four patients were alive at the time of the study. Two patients expired during the period of follow-up from unrelated causes. CONCLUSIONS: EVAR is an effective modality for the management of AAAs in the coexistence of a transplanted kidney. It can be performed with minimal morbidity and mortality without harming the transplanted kidney. Special consideration should be given to device configuration to minimize damage to the renal graft.