Revised duplex criteria and outcomes for renal stents and stent grafts following endovascular repair of juxtarenal and thoracoabdominal aneurysms Walid.

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Revised duplex criteria and outcomes for renal stents and stent grafts following endovascular repair of juxtarenal and thoracoabdominal aneurysms Walid Mohabbat, MD, Roy K. Greenberg, MD, Tara M. Mastracci, MD, Marcelo Cury, MD, Jose P. Morales, MD, Adrian V. Hernandez, MD, PhD Journal of Vascular Surgery Volume 49, Issue 4, Pages 827-837 (April 2009) DOI: 10.1016/j.jvs.2008.11.024 Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 1 Modification of Diet in Renal Disease (MDRD) formula. Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003;139(2):137-47. GFR, Glomerular Filtration Rate; Pcr, polymerase chain reaction. Journal of Vascular Surgery 2009 49, 827-837DOI: (10.1016/j.jvs.2008.11.024) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 2 Kaplan-Meier curves for freedom from occlusion in months. The solid line represents those treated with a covered stent and the dashed line represents those treated with an uncovered stent. The development of renal stent occlusion between the two groups was not statistically different. Hazard ratio (HR) for occlusion (covered vs uncovered): 0.5 (0.2-1.4), P = 0.2. Journal of Vascular Surgery 2009 49, 827-837DOI: (10.1016/j.jvs.2008.11.024) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 3 Parametric receiver operator curve (ROC) analysis for the detection of renal stent occlusion using peak systolic velocity (PSV) and renal aortic ratio (RAR). For PSV the area under the ROC curve is 0.91 (95% confidence interval [CI] 0.88-0.94) indicating good discrimination between those with stent occlusion and no occlusion. For RAR the area under the ROC curve is 0.88 (95% CI 0.84-0.91) indicating good discrimination between those with stent stenosis and no stenosis. Journal of Vascular Surgery 2009 49, 827-837DOI: (10.1016/j.jvs.2008.11.024) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 4 Kaplan-Meier curves for freedom from stenosis in months. The solid line represents those treated with a covered stent and the dashed line represents those treated with an uncovered stent. The development of renal stent stenosis between the two groups was statistically different. Hazard ratio (HR) for stenosis (covered vs uncovered): 0.4 (0.2-0.9), P = .04. Journal of Vascular Surgery 2009 49, 827-837DOI: (10.1016/j.jvs.2008.11.024) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 5 Parametric receiver operator curve (ROC) analysis for the detection of renal stent stenosis using peak systolic velocity (PSV) and renal aortic ratio (RAR). For PSV the area under the ROC curve is 0.99 (95% confidence interval [CI] 0.99-1.00) indicating optimal discrimination between those with stent stenosis and no stenosis. For RAR, the area under the ROC curve is 0.91 (95% CI 0.82-0.96) indicating good discrimination between those with stent stenosis and no stenosis. Journal of Vascular Surgery 2009 49, 827-837DOI: (10.1016/j.jvs.2008.11.024) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 6 Flow diagram demonstrating renal events during follow-up (F/U) of all patients treated using uncovered renal stents. GFR, Glomerular Filtration Rate. Journal of Vascular Surgery 2009 49, 827-837DOI: (10.1016/j.jvs.2008.11.024) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 7 Flow diagram demonstrating renal events during follow-up (F/U) of all patients treated using covered renal stents. GFR, Glomerular Filtration Rate. Journal of Vascular Surgery 2009 49, 827-837DOI: (10.1016/j.jvs.2008.11.024) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions

Fig 8 Shown are postoperative computed tomography (CT) scan reconstructions of a patient in whom a right renal artery kink (A, B) was recognized intra-operatively and treated with a self-expanding stent at the distal renal stent edge to renal artery junction (C, D) (arrow). Journal of Vascular Surgery 2009 49, 827-837DOI: (10.1016/j.jvs.2008.11.024) Copyright © 2009 The Society for Vascular Surgery Terms and Conditions