Theoretical mechanism of temporary renal function improvement after abdominal aortic aneurysm surgery: Applications for clinical imaging and laboratory data

We evaluated the effects of changes in blood flow due to abdominal aortic aneurysm (AAA) surgery by using a simple zero-dimension model and applied theoretical values to clinical data. The zero-dimension electronic circuit model and diagram of blood flow distribution were created by setting the resistance of the aorta, bilateral iliac arteries, renal arteries, and aneurysm. Resistance of the aneurysm and resistance of the aorta before surgery were compared with that of the aorta after surgery. We set the radius length of each anatomical parameter to calculate theoretical values. Renal flow increased 13.4% after surgery. Next, we analyzed contrast-enhanced computed tomography data of 59 patients who underwent AAA surgery. A total of 19 patients were treated with a Y graft and 7 patients were treated with a straight graft during open surgery. However, 33 patients were treated with a bifurcated stent graft. A significant linear relationship between the increased estimated glomerular filtration rate (eGFR) ratio and the decreased aneurysm ratio was found only for the straight graft group. Using a circuit model, renal blood flow theoretically increased after AAA surgery. Clinically, there was a correlation between volume regression and eGFR improvement only in the limited AAA group.