Renal Function Impairment in Patients Undergoing Elective EVAR vs. Elective Open Repair During Follow up Period: A Systematic Review of the Literature

Author(s): Konstantinos Spanos , Christos Karathanos , Athanasios Athanasoulas , Vasileios Saleptsis , Ioannis Vasilopoulos , Sokol Xhepa , Miltiadis Matsagkas , Athanasios D. Giannoukas .

Journal Name: Current Vascular Pharmacology

Volume 15 , Issue 2 , 2017

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Abstract:

Background: Endovascular (EVAR) or open surgical (OSR) repair are current treatment options for abdominal aortic aneurysm (AAA).

Objective: To produce a systematic review comparing the impact of these 2 treatment options on renal function during mid- and long term follow up.

Methods: The MEDLINE, EMBASE and Cochrane databases and key references were searched.

Results: Six studies were included from 2000 to 2016, (4 retrospective and 2 RCT studies) reporting on 2,102 patients (54%; 1096 EVAR, 46%; 1006 OSR). The mean age in EVAR group ranged from 69.4 to 73.8 years (91% males), and in OSR group from 68 to 73.6 years (91% males). The data were too heterogeneous to perform a meta-analysis. All studies used GFR (Glomerular Filtration Rate) or estimated GFR (eGFR) to record renal function. The commonest risk factors were the presence of hypertension (77.5%), hyperlipidaemia (48.3%), coronary artery disease (42%) and smoking (37.8%). During follow up, new events of renal impairment (increase >20% in GFR) in EVAR patients and in OSR patients were 58 (5.3%) and 52 (5.2%), respectively. The mean GFR was decreased during follow up period in both types of the procedure.

Conclusion: There is lack of definitive evidence to prove the superiority of OSR over EVAR regarding renal function in the post-operative follow up period. It appears that renal impairment may occur after both interventions. Further prospective research is needed to clarify the issue.

Keywords: Endovascular abdominal aortic aneurysm repair, open surgical aortic aneurysm repair, renal impairment, renal function.

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Article Details

VOLUME: 15
ISSUE: 2
Year: 2017
Page: [103 - 111]
Pages: 9
DOI: 10.2174/1570161114666161003094136
Price: $58

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