Thoracoabdominal aortic aneurysm open repair with bilateral multiple renal arteries

Multiple renal arteries are a common renal vascular variant. A study with 800 kidneys from cadaver donors demonstrated 1% prevalence of quadruple renal arteries.1 During thoracoabdominal aortic aneurysm (TAAA) repair, this anomaly implies longer time of renal ischemia and well-defined reperfusion strategy.2 Acute kidney injury during TAAA repair is a common complication with 6% to 7% incidence.3,4 It can be prevented by histidine-tryptophan-ketoglutarate solution (Custodiol; Dr Franz-K öhler Chemie GmbH, Bensheim, Germany) renal perfusion.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Tags: Vascular images Source Type: research

Related Links:

Some studies suggest celiac artery coverage during elective endovascular thoracoabdominal aortic aneurysm (TAAA) repair is safe given sufficient collateralization of visceral organ perfusion from the superior mesenteric artery. However, there is concern that celiac artery coverage may lead to increased risk of foregut or spinal cord ischemia with an attendant increased risk of mortality. We sought to investigate rates of bowel ischemia, spinal cord ischemia and 30-day mortality associated with celiac artery coverage during TEVAR and complex EVAR.
Source: Annals of Vascular Surgery - Category: Surgery Authors: Tags: Clinical Research, Basic Science Source Type: research
Juxtarenal aortic surgery induces renal ischaemia reperfusion, which contributes to systemic inflammatory tissue injury and remote organ damage. Renal cooling during suprarenal cross clamping has been shown to reduce renal damage. It is hypothesised that renal cooling during suprarenal cross clamping also has systemic effects and could decrease damage to other organs, like the sigmoid colon.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research
Introduction: Two-stage-procedures is a common strategy in the endovascular repair of thoraco-abdominal aortic aneurysms (TAAA), in order to maintain a temporary sac perfusion for spinal cord preconditioning to ischemia. However, the temporary sac perfusion can lead to coagulative disorders determined by platelet and coagulative factors consumption. Aim of present study was to evaluate possible coagulative disorders and spontaneous haemorrhagic events in two-stage vs single stage endovascular TAAA treatment.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
Introduction - Branched endovascular aortic repair (BEVAR) has become an accepted option for treatment of thoracoabdominal aortic aneurysms (TAAA). Staged procedures with temporary aneurysm sac perfusion (TASP) were shown to reduce the risk of spinal cord ischemia in patients with extended aortic aneurysmal disease. However, only few data about the risk of perioperative mesenteric ischemia are available.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
CONCLUSIONS: Renal ischaemia/reperfusion injury after suprarenal cross clamping decreased microcirculatory flow, increased systemic ROS production, leukocyte infiltration, and I-FABP leakage in the sigmoid colon. Cold renal perfusion was superior to warm perfusion and reduced renal damage and had beneficial systemic effects, reducing sigmoid damage in this experimental study. PMID: 31791617 [PubMed - in process]
Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
Juxtarenal aortic surgery induces renal ischaemia reperfusion, which contributes to systemic inflammatory tissue injury and remote organ damage. Renal cooling during suprarenal cross clamping has been shown to reduce renal damage. It is hypothesised that renal cooling during suprarenal cross clamping also has systemic effects and could decrease damage to other organs, like the sigmoid colon.
Source: European Journal of Vascular and Endovascular Surgery - Category: Surgery Authors: Source Type: research
CONCLUSIONS: Concomitant upper body perfusion by the transapical aortic approach contributes to avoidance of brain and heart complications and maintaining spinal cord circulation under deep hypothermic DTAA/TAAA surgery. PMID: 31640318 [PubMed - as supplied by publisher]
Source: The Journal of Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: J Cardiovasc Surg (Torino) Source Type: research
Abstract OBJECTIVES: With a focus on renal function, the goal of this multicentre study was to assess peri-operative complications and late mortality of open surgical repair (OSR) of juxtarenal abdominal aortic aneurysms (JRAAA). METHODS: From February 2005 to December 2015, 315 consecutive patients undergoing elective OSR of a JRAAA in five French academic centres were evaluated retrospectively. The definition of JRAAA was an aortic aneurysm extending up to but not involving the renal arteries, i.e., a short neck
Source: PubMed: Eur J Vasc Endovasc ... - Category: Surgery Authors: Tags: Eur J Vasc Endovasc Surg Source Type: research
ConclusionsAscending aortic stent placement for ascending aortic disease is feasible and is associated with favorable aortic remodeling. Despite persistent perfusion to the false lumen in a subset of patients, there is minimal aortic dilation at short-term follow-up with excellent survival.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
This study investigated whether preservation of pelvic perfusion with iliac branch devices (IBDs) decreases the incidence of ischemic colitis.
Source: Journal of Vascular Surgery - Category: Surgery Authors: Source Type: research
More News: Abdominal Aneurysm Repair | Aortic Aneurysm | Chemistry | Gastroschisis Repair | Germany Health | Perfusion | Study | Surgery | Urology & Nephrology