Coverage of Accessory Renal Arteries During Endovascular Aortic Aneurysm Repair: What Are the Consequences and the Implications for Clinical Practice?
Coverage of Accessory Renal Arteries During Endovascular Aortic Aneurysm Repair: What Are the Consequences and the Implications for Clinical Practice?
复制标题
主动脉瘤腔内修复术中副肾动脉的覆盖：对临床实践有何后果和影响？
DOI：
10.1177/0003319718771249
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发表时间：
2019
期刊：
影响因子：
2.8
通讯作者：
J. Raffort
中科院分区：
文献类型：
--
作者：
F. Lareyre;Frédéric Panthier;Elixène Jean;R. Hassen;J. Raffort
副肾动脉（ARA）是一种解剖变异，可能会对主动脉瘤腔内修复术（EVAR）造成挑战。本综述旨在总结腹主动脉瘤腔内修复术期间ARA覆盖后术后结局的现有知识。我们进行了系统的文献综述。2017年9月检索MEDLINE数据库，纳入8项相关研究。腹主动脉瘤腔内修复术患者的ARA频率在9.5%和16.2%之间变化，ARA覆盖率在5.2%和9.4%之间变化。4份报告未观察到术后肾功能的任何显著变化，而1项研究报告了ARA覆盖后早期一过性肌酐升高。肾梗死的发生率为20%~ 84%。5项研究未观察到与ARA覆盖相关的内漏，而1项研究报告了18例ARA覆盖患者中3例发生II型内漏。未观察到血压、死亡率和平均住院时间的显著变化。ARA覆盖范围可能会对肾脏和血管造成影响，但都不是关键性的。进一步的研究可能有助于确定术前标准，这可能有助于在ARA覆盖之前选择最合适的手术方法。
An accessory renal artery (ARA) represents an anatomic variation which can challenge endovascular aortic aneurysm repair (EVAR). The aim of this review was to summarize the current knowledge on postoperative outcomes following ARA coverage during EVAR. We performed a systematic literature review. The MEDLINE database was searched on September 2017, and 8 relevant studies were included. The frequency of ARA in patients undergoing EVAR varied between 9.5% and 16.2%, and the frequency of ARA coverage varied between 5.2% and 9.4%. Four reports did not observe any significant changes on postoperative renal function, whereas 1 study reported an early transient increase in creatinine after ARA coverage. The occurrence of renal infarct varied from 20% to 84%. Five studies did not observe endoleaks related to ARA coverage, whereas one reported the occurrence of type II endoleaks in 3 of 18 patients who had ARA coverage. No significant change in blood pressure, mortality, and mean length of hospital stay was observed. The ARA coverage can potentially have renal and vascular consequences, but none of them were critical. Further studies may be useful to identify preoperative criteria that may help to choose the most appropriate surgical approach before ARA coverage.