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Therefore, intraoperative organ protection during supra-renal clamping is decisive for the outcome. This study describes the use of a low-profile extracorporeal circulation (LPECC) for selective renal perfusion in open surgery of JAAA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From 2018 to 2024, 23 patients with JAAA underwent open aortic repair with suprarenal cross-clamping with organ protection by LPECC. This retrospective case series without control group investigated the effect of pressure- and volume-controlled renal perfusion during clamping on clinical outcome in terms of prevention of AKI after open surgery. To classify postoperative renal dysfunction, the RIFLE classification (risk, injury, failure, loss, end-stage renal disease) was used. AKI was defined in the postoperative course as a decrease in eGFR of more than 50% (RIFLE class\u2009\u2265\u20092). Renal function was monitored after 30-days and 1-year with regard to the need for dialysis, course of renal parameters and the occurrence of complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The intraoperative use of the LPECC was not associated with any intraoperative complications. In the postoperative course, 17% developed temporary AKI (RIFLE class\u2009\u2265\u20092,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094) of which 3 patients required dialysis. During 30-days and 1-year follow-up, the retention values recovered and decreased to the preoperative level. None of the investigated patients required long-term dialysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Monitored pressure- and volume-controlled renal perfusion could improve management and outcome in patients with JAAA. LPECC represents a safe and feasible surgical method for renal protection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-026-05549-7","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T11:57:49Z","timestamp":1769601469000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced perfusion strategy for renal protection in juxtarenal aortic aneurysms: a pilot study"],"prefix":"10.1186","volume":"26","author":[{"given":"Melanie","family":"Rusch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grischa","family":"Hoffmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nawar","family":"Alasad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene","family":"Rusch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"5549_CR1","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/j.jvs.2007.12.007","volume":"47","author":"AW Knott","year":"2008","unstructured":"Knott AW, Kalra M, Duncan AA, Reed NR, Bower TC, Hoskin TL, et al. 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