Evaluation of anesthetic management and renal function in open and endovascular repair of abdominal aortic aneurysm

Background : Since 2007, the number of patients receiving endovascular aneurysm repairs (EVARs) is increasing in Japan. Although EVAR is less invasive and has a lower short-term mortality, it has no long-term advantages and may lead to deterioration of renal function. Methods : We retrospectively evaluated anesthetic management and renal function in patients undergoing EVAR and open repair (OR) between July 2010 and June 2011. Results : Sixty-three patients (EVAR 33, OR 30) were studied. The average age of patients was significantly older in the EVAR group, and the duration of surgery and anesthesia were longer in the OR group. Despite lower blood loss in the EVAR group compared with the OR group, a massive hemorrhage (1,563 g) occurred in the EVAR group. The renal function of the EVAR group did not deteriorate within 1 year after surgery. However, the rate of acute kidney injuries (AKI) was higher in patients with renal dysfunction before operation than in patients with normal renal function. Conclusions : Although EVAR is less invasive than OR, anesthesiologists should pay attention to pre-operative comorbidity and massive hemorrhage during the operation. To avoid postoperative renal dysfunction, it is important to protect the kidney during surgery.