AB031. 118. Acute kidney injury in pararenal abdominal aortic aneurysm repair

Background: Pararenal abdominal aortic aneurysms are defined by an insufficient aortic neck between the aneurysm and the renal arteries. Sixteen percent of patients with abdominal aortic aneurysm (AAA) have pararenal aneurysms. Due to an insufficient sealing zone, open surgical repair (OSR) of pararenal AAAs is the gold standard while endovascular repair is reserved for those unfit for surgery. Renal outcomes in this cohort may provide insight into potential utility of endovascular techniques in certain cohorts.

Methods: An existing data base of pararenal aneurysms between 2004 and 2015 was used to gleam information regarding the therapeutic option used. Patient Administration Systems (PAS) was used to identify peri operative creatinine values. Renal events were defined by the RIFLE criteria.

Results: Of 437 AAA cases between 2003 and 2015, 88 were Pararenal aneurysms. 40 (45%) were OSR and 48 (55%) were repaired by endovascular approach. Thirteen (32%) of the OSR group experienced a renal event compared to 3 (7.5%) of those repaired endovascularly.

Conclusions: The rate of renal events for OSR is higher compared to previous literature while the rate of endovascular renal events rate was lower. Midterm and long-term studies are required but these early results may indicate that certain cohorts undergoing OSR may benefit from endovascular repair.

Keywords: Abdominal aortic aneurysm (AAA); juxtarenal; acute kidney injury; chronic kidney disease