Juxtarenal aneurysm. Comparative study with infrarenal abdominal aortic aneurysm and proposition of a new classification.
Eur J Vasc Endovasc Surg
; 22(2): 169-74, 2001 Aug.
Article
in En
| MEDLINE
| ID: mdl-11472053
ABSTRACT
OBJECTIVE:
to propose an anatomical classification of juxtarenal aortic aneurysm (JRA) that relates to their epidemiology and the result of surgical repair. MATERIAL ANDMETHODS:
retrospective study of 53 JRA and 376 infrarenal aortic aneurysm (AAA) operated between January 1989 and August 1999.RESULTS:
perioperative mortality after JRA repair was 19% for type A (interrenal), 13% for type B (aneurysm of one or two renal origins) and 4% for type C (no infrarenal neck). These differences were not significant. The overall perioperative mortality after JRA repair (11%) was significantly higher than mortality of AAA (3%p<0.01). Postoperative morbidity after JRA repair was 62% for type A, 75% for type B and 33% for type C. Postoperative morbidity after type B repair was significantly more frequent than after type C (p<0.001). The overall postoperative morbidity (51%) was significantly more frequent than after AAA repair (26%p<0.01). Preoperative ischaemic heart disease, aortic clamping above the coeliac axis and aortic proximal clamping longer than 30 min were significant risk factors for death after JRA repair. Survival by life-table analysis at five years after JRA repair and AAA repair were respectively 73%+/-7% and 76%+/-3%.CONCLUSION:
there is a less favourable outcome after JRA repair as compared to AAA repair. The complexity of the surgical procedure requires accurate preoperative morphological assessment. The proposed classification of juxtarenal aneurysms may be helpful in guiding surgical access.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Aortic Aneurysm, Abdominal
Type of study:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Eur J Vasc Endovasc Surg
Year:
2001
Document type:
Article