Renal Function Deterioration in Complex Aortic Repair

Deterioration of renal function is one of the most important determinants of early and late mortality after complex endovascular aortic repair. Renal function deteriorates in these patients because of multiple factors, including ischemia, catheter manipulation, embolization, contrast nephropathy, and occlusion of the renal arteries from intra-procedural complications or stent thrombosis. Approximately one third of the patients experience some loss of renal function and most recover to baseline values within three to six months. This chapter summarizes results of endovascular repair using fenestrated and branched endografts with respect to renal function outcomes.