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  1. C100 医学部/医学系研究科
  2. C100a 雑誌掲載論文
  3. 学術雑誌

Suprarenal fixation is associated with worse midterm renal function after endovascular abdominal aortic aneurysm repair compared with infrarenal fixation

http://hdl.handle.net/2237/00032256
b686d6b7-60b6-4a08-b69e-75368480cee6
名前 / ファイル ライセンス アクション
article.pdf article (290.7 kB)
Item type 学術雑誌論文 / Journal Article(1)
公開日 2020-05-26
タイトル
タイトル Suprarenal fixation is associated with worse midterm renal function after endovascular abdominal aortic aneurysm repair compared with infrarenal fixation
著者 Banno, Hiroshi

× Banno, Hiroshi

WEKO 99171

Banno, Hiroshi

Search repository
Ikeda, Shuta

× Ikeda, Shuta

WEKO 99172

Ikeda, Shuta

Search repository
Kawai, Yohei

× Kawai, Yohei

WEKO 99173

Kawai, Yohei

Search repository
Fujii, Takayuki

× Fujii, Takayuki

WEKO 99174

Fujii, Takayuki

Search repository
Akita, Naohiro

× Akita, Naohiro

WEKO 99175

Akita, Naohiro

Search repository
Takahashi, Noriko

× Takahashi, Noriko

WEKO 99176

Takahashi, Noriko

Search repository
Sugimoto, Masayuki

× Sugimoto, Masayuki

WEKO 99177

Sugimoto, Masayuki

Search repository
Kodama, Akio

× Kodama, Akio

WEKO 99178

Kodama, Akio

Search repository
Komori, Kimihiro

× Komori, Kimihiro

WEKO 99179

Komori, Kimihiro

Search repository
権利
権利情報 © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
キーワード
主題Scheme Other
主題 EVAR
キーワード
主題Scheme Other
主題 Renal function
キーワード
主題Scheme Other
主題 Suprarenal fixation
抄録
内容記述 Background: Several reports have indicated that suprarenal (SR) fixation may impair renal function after endovascular abdominal aortic aneurysm repair (EVAR). However, most were short-term or at most, 1-year observational studies; therefore, the midterm effects on renal function remain unclear. This study aimed to identify predictors of midterm renal dysfunction after EVAR and compare renal outcomes in patients after EVAR with SR and infrarenal (IR) fixation. Methods: A total of 467 patients who underwent EVAR of nonruptured IR abdominal aortic aneurysm between 2007 and 2014 were reviewed in a prospectively collected database. Patients on hemodialysis at baseline were excluded. Among the remaining patients, those with 3-year laboratory testing were included in this study. Patients who developed acute kidney injury were excluded from the late renal function estimation. Predictors of 3-year renal function decline were estimated using logistic regression analysis. In addition, patients undergoing EVAR with IR (IR group) and SR fixation devices (SR group) were propensity matched by age, sex, baseline renal function, baseline aneurysm diameter, comorbidities, smoking habits, and regular use of medicines that may act on kidney function. Changes in renal function after surgery were compared between the IR group and the SR group. Results: During the study period, 237 patients (102 IRs and 135 SRs) were followed up with laboratory testing 3 years after surgery. Logistic regression analysis revealed that the use of a SR fixation device was independently predictive of a more than 20% decrease in the estimated glomerular filtration rate at 3 years after EVAR (odds ratio, 2.06; 95% confidence interval, 1.18-3.58; P = .011). Eleven patients who developed acute kidney injury (1 IR and 10 SRs) were excluded from the subsequent analysis. After propensity score matching, 87 pairs were selected (mean age, 77.2 ± 6.3 years; 151 males [86.8%]). The mean follow-up duration was 5.5 ± 1.8 years. In the SR group, estimated glomerular filtration rate at 3 years after surgery decreased significantly more than that in the IR group (mean of 17.8% vs 11.6%, respectively; P = .034). Conclusions: This study suggests that, compared with EVAR with IR endograft fixation, EVAR with SR endograft fixation is associated with worse outcomes for midterm renal function.
内容記述タイプ Abstract
内容記述
内容記述 ファイル公開:2021-02-01
内容記述タイプ Other
出版者
出版者 Elsevier
言語
言語 eng
資源タイプ
資源タイプresource http://purl.org/coar/resource_type/c_6501
タイプ journal article
DOI
関連識別子
識別子タイプ DOI
関連識別子 https://doi.org/10.1016/j.jvs.2019.03.061
ISSN(print)
収録物識別子タイプ ISSN
収録物識別子 0741-5214
書誌情報 Journal of Vascular Surgery

巻 71, 号 2, p. 450-456, 発行日 2020-02
著者版フラグ
値 author
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