Comparison of Hybrid Vascular Grafts and Standard Grafts in Terms of Kidney Injury for the Treatment of Thoraco-Abdominal Aortic Aneurysm

Background We present a comparison of renal function outcomes during HTAR with the use of a new hybrid vascular graft (GHVG) or standard graft. Methods It is a multicenter, retrospective, observational study. Between January 2015 and March 2019, 36 patients were treated with HTAR. We compared HTAR performed with the use of the GHVG and with the use of standard bypass graft. Primary outcome measures were hospital mortality, acute kidney injury (AKI) at 30 days and GHVG patency. Results Mean GHVG ischemia time was significantly lower for both renal arteries (right: GHVG, 4 +/- 2 vs. standard graft, 15 +/- 7 min; 95% CI 2.23-6.69, P < 0.001; left: GHVG, 3 +/- 2 vs. standard graft, 13 +/- 7 min; 95% CI 2.44-5.03, P < 0.001). Hospital mortality was 17% (6/36); while mortality did not differ between the two groups, postoperative acute kidney injury rate was 30.5% (11/36 patients) and was more common in the standard graft group (7% vs. 29%; OR 3.2, P = 0.074). Estimated primary patency was 92% +/- 2 (95% CI 79.5-97%) at 36 months and was not different between the two groups (GHVG 94% +/- 6 vs. standard graft 91% +/- 6; log-rank chi(2) = 0.260, P = 0.610). Conclusions In our experience of HTAR, ischemia time was significantly shorter and postoperative AKI occurrence was lower with GHVG if compared to standard graft bypass, with satisfactory midterm patency rate comparable to that of standard graft bypass.