Abstract
A 72-year-old man underwent infrarenal abdominal aortic aneurysm surgery with a retroperitoneal approach 15 years previously. The maximum AAA diameter proximal to the previous graft was 55 mm and the left renal artery (RA) arose from the aneurysm, so he was admitted with a diagnosis of pararenal abdominal aortic aneurysm (PRAAA). Operation was performed through median laparotomy. Soon after suprarenal aortic cross-clamp, perfusion from the right axillary artery to the left RA was performed for renal protection. The graft used for aneurysm repair was a knitted Dacron graft. Perfusing to the left RA, proximal anastomosis was performed and the left RA was reconstructed. The serum creatinine level was 1.7 mg/dl on postoperative day 1, it returned to the preoperative serum concentration in 4 days after surgery. Though intestinal obstruction was caused by surgery, there was no deterioration of renal function during his hospital stay. He was discharged 37 days after surgery. Thus, perfusing from the axillary artery to the RA proved safe and useful for protection of renal function in the surgical treatment of PRAAA.
