Abdominal Aortic Aneurysm Repair in Patients with End Stage Renal Disease

Abstract

Objective : Abdominal aortic aneurysm (AAA) in patients with end stage renal disease (ESRD) represents a challenging therapeutic problem. This study was undertaken to analyze the surgical outcome of AAA repair in patients with ESRD and discuss the optimal peri-operative management of problems that resulted.

Methods : Between January 1995 and January 2005, 11 patients with ESRD underwent abdominal aortic aneurysm repair. All patients were under chronic haemodialysis. Risk factors related to surgical morbidity were evaluated. Results : The average age was 68 years (57–84 years). Nine patients were men: 8 were hypertensive, 6 had diabetes, 4 had coronary artery disease, 3 had suffered a previous stroke, 3 had prior myocardial infarct and 8 were smokers. The duration of haemodialysis was 19 months (range 2 to 46 months). Five of the 11 patients had bilateral common iliac aneurysms in addition to the abdominal aortic aneurysm. The average diameter of infrarenal AAA was 6 cm (4.8–7.5). The mean duration of operation was 191 min. All patients underwent haemodialysis on the day before operation with an average period of 8.5 hours (6–12) and 2 to 20 hours postoperatively.

The mean follow-up was 11.5 months (range 1 to 93 months). None of the patients died during the 30-day postoperative period. Two patients died from heart failure 3 and 7 months later.

Conclusion : Abdominal aortic aneurysm can be repaired in patients with end stage renal disease with good results, despite the increased morbidity and mortality of this population.

Key Words:

• Aortic aneurysm
• end stage renal disease
• dialysis

Additional information

Notes on contributors

C. N. Bakoyiannis

C. N. Bakoyiannis, M.D. 17 Agiou Thoma 11527, Goudi, Laiko Hospital First Department of Surgery Athens, Greece Fax: [phone] E-mail: [email protected]