The Impact of Perioperative Acute Kidney Injury on Early and Follow-up Mortality of Fenestrated/Branched Endovascular Aortic Repair in Juxtarenal/Pararenal and Thoracoabdominal Aneurysms

Q: What are the key findings of this study?

Perioperative acute kidney injury after fenestrated/branched endovascular aortic repair was associated with significantly lower 5-year survival compared to patients without AKI (47% vs 64%, HR 1.5).

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Juxtarenal/pararenal abdominal aortic aneurysms and thoracoabdominal aneurysms (n=466). Intervention: Perioperative Acute Kidney Injury (AKI) vs. No AKI. Primary outcome: 5-year survival (HR 1.5, 95% CI 1.2-2.2, p=0.009).

Enrico Gallitto; Gianluca Faggioli; Francesca Feroldi; Antonio Cappiello; Gaetano La Manna; Pietro Fiorio; Paolo Spath; Stefania Caputo; Andrea Vacirca; Rodolfo Pini; Mauro Gargiulo

doi:10.1016/j.jvs.2026.03.470

June 4, 2026Journal of Vascular SurgeryOpen Access

The Impact of Perioperative Acute Kidney Injury on Early and Follow-up Mortality of Fenestrated/Branched Endovascular Aortic Repair in Juxtarenal/Pararenal and Thoracoabdominal Aneurysms

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Key result

Perioperative AKI after fenestrated/branched EVAR is linked to ~50% higher 5-year mortality.

HR 1.5
95% CI 1.2-2.2
P=0.009
n=466

Why the study?

Does perioperative acute kidney injury impact early and follow-up mortality in patients undergoing fenestrated/branched endovascular aortic repair?

Key Points

To analyze the incidence, risk factors, and prognostic impact of perioperative acute kidney injury on early and long-term mortality following fenestrated and branched endovascular aortic repair.
Conducted a cohort study of patients undergoing fenestrated/branched endovascular aortic repair (F/B-EVAR) for juxtarenal, pararenal, and thoracoabdominal aneurysms between January 2010 and June 2025.
Staged perioperative acute kidney injury (AKI) using the 2012 Kidney Disease Improving Global Outcomes criteria and assessed survival over a mean follow-up of 40 6 17 months.
Estimated 5-year survival was significantly lower in patients with AKI versus without AKI (47% vs 64%; log-rank P < .001), and AKI independently predicted follow-up mortality (HR: 1.5; 95% CI, 1.2-2.2; P = .009), rising to HR 9.4 (95% CI, 4.1-21.4; P < .001) for stage III.

Study Design

Type

Cohort (n=466)

Multicenter

No

Structured PICO

Does perioperative acute kidney injury impact early and follow-up mortality in patients undergoing fenestrated/branched endovascular aortic repair?

P

Population

Patients who underwent fenestrated/branched endovascular aortic repair (F/B-EVAR) for juxtarenal/pararenal abdominal aortic aneurysms and thoracoabdominal aneurysms between January 2010 and June 2025. 45% had thoracoabdominal aneurysms, and 31% had preoperative chronic renal impairment.

I

Intervention

Fenestrated/branched endovascular aortic repair (F/B-EVAR)

C

Comparator

Patients without postoperative acute kidney injury (for survival analysis)

O

Outcome

Incidence of perioperative acute kidney injury (AKI), its risk factors, and the impact on patient survival (early and follow-up mortality)hard clinical

Main Result

Effect estimate: HR 1.5 (95% CI 1.2-2.2)

Absolute Event Rate: 47% vs 64%

p-value: p=0.009

Implication

Perioperative acute kidney injury after fenestrated/branched endovascular aortic repair is common (19%) and independently predicts both hospital and long-term mortality.

Abstract

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Discussion

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Cite This Study

Gallitto et al. (2026) conducted a cohort in Juxtarenal/pararenal abdominal aortic aneurysms and thoracoabdominal aneurysms (n=466). Perioperative Acute Kidney Injury (AKI) vs. No AKI was evaluated on 5-year survival (HR 1.5, 95% CI 1.2-2.2, p=0.009). Perioperative acute kidney injury after fenestrated/branched endovascular aortic repair was associated with significantly lower 5-year survival compared to patients without AKI (47% vs 64%, HR 1.5).

synapsesocial.com/papers/6a3c2356d15afadd906fa006 https://doi.org/10.1016/j.jvs.2026.03.470

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The Impact of Perioperative Acute Kidney Injury on Early and Follow-up Mortality of Fenestrated/Branched Endovascular Aortic Repair in Juxtarenal/Pararenal and Thoracoabdominal Aneurysms

Key Points

Study Design

Structured PICO

Main Result

Implication

Abstract

Discussion

Cite This Study

The Impact of Perioperative Acute Kidney Injury on Early and Follow-up Mortality of Fenestrated/Branched Endovascular Aortic Repair in Juxtarenal/Pararenal and Thoracoabdominal Aneurysms

Key Points

Study Design

Structured PICO

Main Result

Implication

Abstract

Discussion

Cite This Study

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