Anatomic study of juxta renal XXXX : impact on fenestrated stent-grafts.

@entity1 @entity8 @entity439 @entity6029
BACKGROUND: Fenestrated stent-grafts allow for treatment of @entity1 with @entity439 ( @entity439 ) when they present with contraindications for conventional treatment. The fenestrated module is a custom-made module, specially designed to fit a specific @entity1 , using computed tomographic scan measurements, which entails manufacturing delay and high cost. The aim of our study was to evaluate the possibility to reproduce the interrenal aorta anatomy to design a standard fenestrated module that would fit the maximum number of @entity1 with @entity439 . METHODS: On a three-dimensional working station, we analyzed 289 preoperative computed tomographic scan results of @entity1 with @entity439 and who were treated with fenestrated stent-grafts comprising two fenestrations for the renal arteries and a scallop for the @entity6029 ( @entity6029 ). On curvilinear reconstructions, we successively measured the interrenal aorta diameter, its orientation, as well as the height of each renal ostium, taking the ostium center of the @entity6029 as a reference mark. Later, a statistical analysis of these measures distribution was performed so as to design a fenestrated module that would fit the maximum number of @entity1 . RESULTS: The center of the @entity8 presented with a median orientation of 82.5   (range, 37.5-150) and a median distance of 9 mm (range, 0-30), in relation to the @entity6029 ostium. The ostium center of the right renal artery presented with a median orientation of 285   (range, 240-337.5) and a median distance of 8 mm (range, 3-30), in relation to the @entity6029 ostium. By positioning the current renal fenestrations (6-mm wide), on the basis of the calculated median positions, in our series, only 20% of the @entity1 could be treated with a standard fenestrated module. Should the diameter of these fenestrations be increased by 10 mm, it would then be possible to treat 50% of our @entity1 . CONCLUSION: The anatomy of the interrenal aorta and its branches is quite reproducible to design standard fenestrated stent-grafts that could treat half of the @entity1 with @entity439 .
