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Renal function after aortic stent-grafting including coverage of renal arterial ostia.

Considerable experience has been gained with endoluminal stent-graft techniques for the treatment of infrarenal aortic aneurysms. The inclusion of uncovered suprarenal stents eases the treatment of cases with a short, angulated, or bottlenecked proximal neck. However, few data have been published on the effect of a stent-graft crossing renal artery ostia on long-term renal function. We therefore retrospectively analyzed the influence of intra-aortic stent-grafts, including suprarenal fixation on long-term renal function. Thirty-nine patients who received a Gianturco Z stent across renal artery ostia as part of a made-to-measure stent-graft treating an infrarenal aortic aneurysm were evaluated at 6 (all patients) and 30 months (15 patients) after surgery. Renal function evaluation included serum creatinine level, creatinine clearance using the Cockcroft-Gault formula, and renal tomography. Initial technical success was achieved in all patients. There were no minor or major complications. Mean serum creatinine levels were 1.16 +/- 0.25, 1.12 +/- 0.28, and 1.24 +/- 0.25 mg/dL before and 6 and 30 months after endoluminal stent-graft performance, respectively (P = not significant [NS]). Mean creatinine clearances were 60.3 +/- 19.7, 63 +/- 23, and 60.6 +/- 17.5 mL/min before and 6 and 30 months after endoluminal stent-graft performance, respectively (P = NS). Only two patients (5%) had a decrease in glomerular filtration rate greater than 20% at 6 months. Both patients had renal insufficiency before endovascular grafting. Renal function was stable in all patients at 30 months' follow-up. We suggest that renal function is unaffected by coverage of renal arterial ostia with Gianturco Z stents.