The application of renal autotransplantation for complex abdominal aortic disease: A monocentric retrospective experience

Le résumé fourni par la source

Objective For abdominal aortic disease with complex anatomical features or renal insufficiency, endovascular aneurysm repair (EVAR) may not always be an appropriate option. The combination of open surgical repair (OSR) with renal autotransplantation (RAT) has demonstrated a promising efficacy, albeit with limited reported cases. This study presents our experience with RAT in conjunction with traditional OSR or EVAR for managing complex abdominal aortic disease. Methods A retrospective review was conducted on 10 patients with complex abdominal aortic disease, mainly juxtarenal abdominal aortic aneurysm, who underwent RAT between 2012 and 2022 in our center. Data including demographic, clinical, imaging, and surgical details were collected and assessed meticulously. Results The average age of the patients was 59.5 ± 21.8 years. Among them, six patients were diagnosed with juxtarenal abdominal aortic aneurysm, two with endoleak after EVAR, one with aortitis, and one with aortic intimal sarcoma. Eight patients underwent OSR combined with RAT, and two underwent endovascular repair in conjunction with RAT. One patient required temporary hemodialysis postoperatively. The mean serum creatinine and blood urea nitrogen at discharge were 123.2 ± 72.6 μmol/L and 8.67 ± 10.14 mmol/L, respectively, showing no significant variance from the preoperative levels ( P = .19 and P = .52). One patient died perioperatively owing to cerebral hemorrhage, and another was lost to follow-up after discharge. Follow-up computed tomography angiography confirmed excellent patency of arterial reconstruction in eight patients, without persistent renal impairment. Conclusions OSR or EVAR combined with RAT represents a potentially feasible and effective treatment approach for complex abdominal aortic disease.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.