Renal Artery Implantation Angles in Thoracoabdominal Aneurysms and Their Implications in the Era of Branched Endografts

Abstract

The primary location of longitudinal aortic growth will drive the RAIA in a cranial or caudal direction. When the disease process is largely located below the renal ostia, infrarenal aortic lengthening drives the renal ostia cranially, forcing the implantation angle of the renal ostia to be caudally directed. The opposite occurs in type II or III TAAAs, where the bulk of disease is above the renal arteries, driving the ostia down to create RAIAs that are nearly orthogonal to the centerline of flow. Utilization of this data could result in endovascular grafts designed with branches replacing fenestrations for renal artery perfusion.