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July 1994

The Juxtarenal Abdominal Aortic AneurysmA More Common Problem Than Previously Realized?

Author Affiliations

From the Department of Surgical Education, Greenville (SC) Hospital System (Dr Taylor); Division of Vascular Surgery, University of South Florida School of Medicine, Tampa (Dr Mills); and the Vascular Surgery Service, Wilford Hall US Air Force Medical Center, San Antonio, Tex (Dr Fujitani).

Arch Surg. 1994;129(7):734-737. doi:10.1001/archsurg.1994.01420310066011

Objective:  To determine the incidence and treatment outcome of juxtarenal infrarenal aneurysmectomy in a vascular practice minimally biased by tertiary referral.

Design:  A 5-year retrospective review of all aortic operations from our vascular registry was performed, and a case series of juxtarenal aneurysmectomies was analyzed.

Patients:  Of 174 infrarenal aortic aneurysmectomies performed, 27 (15.5%) (95% confidence interval, 10.5% to 21.8%) involved the juxtarenal aorta.

Interventions:  Juxtarenal involvement was unsuspected but found by aortography in 25 (93%) of 27 cases. Resection was performed transabdominally in 20 cases (74%) and retroperitoneally in seven cases (26%).

Main Outcome Measures:  Incidence, operative technique, morbidity, and mortality were analyzed and compared with those of historical controls.

Results:  The incidence of juxtarenal aneurysmectomy was 15.5%. No operative deaths occurred, but there was a 19% incidence of surgical morbidity (including a 7% incidence of transient renal failure). The late survival rate was 89% (follow-up, 1 to 53 months; mean, 18 months).

Conclusions:  Juxtarenal aortic aneurysms are not uncommon. Successful management is possible, even outside the large referral center.(Arch Surg. 1994;129:734-737)