Ko DAISIK, Choi SANGTAE, Lee WONSUK, Kang JINMO, Kim DOOJIN

Endovasküler aort onarımı sonrası stent greft fiksasyon yöntemlerinin pararenal aort çapı ve böbrek fonksiyonu üzerine etkisi

Amaç: Bu çalışmada endovasküler aort onarımı sonrası pararenal aortikçap değişikliklerinin belirlenmesi ve suprarenal fiksayon yöntemlerininböbrek fonksiyonu üzerindeki etkilerinin araştırılması amaçlandı. Çalışma planı: Mayıs 2006 - Ocak 2019 tarihleri arasındaendovasküler aort onarımı yapılan toplam 168 hasta (135 erkek,33 kadın; ort. yaş: 75.2±8.4 yıl; dağılım, 48-93 yıl) retrospektif olarakincelendi. Greft fiksayon yöntemlerinin etkilerini karşılaştırmakiçin pararenal aort çapındaki değişim dört seviyede ölçüldü: çölyakarterin altında, superior mezenterik arterin altında, distal renal arterseviyesinde ve distal renal arter çıkışının 1 cm altında. Suprarenalfiksasyonun böbrek fonksiyonu üzerindeki etkisini değerlendirmekiçin serum kreatinin, glomerüler filtrasyon hızı, kreatinin klirensoranı ve tahmini glomerüler filtrasyon hızının seri ölçümleri yapıldı.İşlem sonrası aort çapı ile ilişkili faktörler incelendi. Bulgular: Aort çapındaki ortalama değişiklik istatistiksel olarakanlamlı olup, yalnızca distal renal arter seviyesi ölçümlerindesuprarenal fiksasyon grubunda %12.9±10 ve infrarenal fiksasyongrubunda %6.19±6.9 idi (p=0.001). Tip I kaçak (p=0.330) veyaböbrek fonksiyonu ve advers olaylar açısından (p>0.107) gruplararasında anlamlı bir fark yoktu. İşlem sonrası aort çapını hesaplamaformülü şuydu: işlem sonrası aort çapı (renal arter seviyesi, mm)=1.845 (suprarenal tespit durumunda) + 1.012 × işlem öncesi aortçapı (renal arter seviyesi, mm) + 0.029 × takip zaman (ay) + 0.039× büyük boy (%) (R2 =0.773, p

Effect of stent graft fixation types on pararenal aortic diameter andrenal function after endovascular aortic repair

Background: This study aims to identify pararenal aortic diameterchanges following endovascular aortic repair and to investigate theeffects of suprarenal fixation on renal function. Methods: Between May 2006 and January 2019, a total of168 patients (135 males, 33 females; mean age: 75.2±8.4 years;range, 48 to 93 years) who underwent endovascular aortic repairwere retrospectively analyzed. To compare the effects of grafttypes, we measured the change in pararenal aortic diameter at fourlevels: below the celiac artery, below the superior mesenteric artery,at the lowest renal artery, and 1 cm below the lowest renal artery.To evaluate the effect of suprarenal fixation on renal function,serial measurements of serum creatinine, glomerular filtration rate,creatinine clearance rate, and estimated glomerular filtration ratewere made. We examined the factors related to post-proceduralaortic diameter. Results: The mean change in the aortic diameter was statisticallysignificant, being 12.9±10% in the suprarenal fixation group and6.19±6.9% in the infrarenal fixation group only at the lowest renalartery level (p=0.001). There was no significant difference in the rate oftype I endoleak (p=0.330) or renal function and adverse events (p>0.107)between the groups. The formula for calculating post-proceduralaortic diameter was as follows: post-procedural aortic diameter (renalartery level, mm) =1.845 (in case of suprarenal fixation) + 1.012 ×pre-procedural aortic diameter (renal artery level, mm) + 0.029 ×follow-up time (months) + 0.039 × oversizing (%) (R2 =0.773, p

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