Objectives: This prospective study compares the impact on the renal function (RF) of conventional open surgery (CO) and EVAR for the treatment of infrarenal abdominal aortic aneurysms (AAA). Materials and Methods: We included 109 patients (51 CO, 58 EVAR). Patients with supra renal clamping were excluded. 48 EVAR had suprarenal fixation (SRF). Serum creatinine was dosed in preoperative, postoperatively at D3, at 1, 3, 6 months, then every 6 months. According to KDIGO (Kidney diseases, improving global outcomes) and the National Kidney Foundation we calculated the rate of glomerular filtration (cRGF) using the MDRD and CKD EAR formulas. A significant aggravation of the RF was defined by a decrease of the cRGF under the threshold value of 60 mL/min in patients without renal insufficiency (CRI). In the event of CRI before treatment (stage 3, cRGF< 60mL/min), the significant threshold of decline of RF was a decrease  20% of the cRGF. Mean values of creatinine and cRGF were compared. A univariate analysis of the risk factors of degradation of RF in EVAR was carried out. Results: The two groups were homogeneous in the preoper- ative period. The mean follow-up was 29 ±4 months in EVAR and 28 ± 7 months after CO. At D3, the mean values of creat- inine and cRGF according to MDRD and CKD EAR were in favor of EVAR (p¼0.03, p¼0.001, p¼0.01, respectively). The incidence of degradation of RF was respectively 6.8% and 22.4% at 12 months and 1.9% and 32.7% at the end of the follow-up after CO and EVAR. The Relative Risk of degra- dation of RF in EVAR compared with CO was respectively 3.2 (95% CI [0.99; 10.8], p¼0.05) at 12 months and 16.7 (95% CI [2.32; 120.4], p<0.001) at the end of the follow-up. Among pa- tients with CRI before treatment, the mean loss of cRGF was 2.2 and 3.1 mL/min at 12 months (p¼0.3) vs. 1.1 and 7.1 mL/ min at the end of the follow-up (p¼0.08), for CO and EVAR, respectively. In univariate analysis, only the diabetes and oral antidiabetic treatments were significantly related to the degradation of RF (p¼0.002, p¼0.01) in the EVAR group, and SRF did not have any influence (p¼0.8). One patient entered in dialysis in the EVAR group at 6 months. Conclusion: With CO, patients are exposed to the risk of postoperative acute renal failure. In the long run, the degrada- tion of the RF was more important after EVAR, particularly in the diabetic patients. The presence of a preoperative CRI should not influence the choice of the surgical technique. http://dx.doi.org/10.1016/j.avsg.2015.06.020 Automated Lumbar Drainage for the Control of the Cerebrospinal Fluid Pressure during Surgery for Thoracoabdominal Aortic Aneurysms Marco Leopardi, Yamume Tshomba, Andrea Kahlberg, Domenico Baccellieri, Germano Melissano, and Roberto Chiesa Service de chirurgie vasculaire, H^ opital San Raffaele, Universit a Vita-Salute, Milan, Italie. Objectives: The perioperative drainage of the cerebrospi- nal fluid (CSF) is a well-established technique for the pro- tection of the spinal-cord during the open surgery of thoracoabdominal aortic aneurysms (TAA). LiquoGuard is a new device of controlled and continuous drainage conceived to guarantee a pressure of the CSF around the values desired and avoid useless drainages. The aim of our study was to establish if the use of LiquoGuard during open surgery for TAA is effective to maintain the desired pressure of CSF to reduce the incidence of the complica- tions compared to the standard catheters of drainage. Materials and Methods: A total of 88 consecutive patients treated for TAA with open surgery between October 2012 and September 2013 were retrospectively studied. 44 patients had CSF drainage with a traditional catheter and 44 with LiquoGuard. The values of the CSF pressure were noted in the two groups at the beginning of intervention (T1), 15 min after aortic clamping (T2), just before unclamping (T3), at the end of the surgery (T4) and four hours after the end of the operation (T5). We recorded the episodes of ischemia of the spinal-cord, intracranial hemorrhage or post lumbar puncture headache, and the mortality rate at 30 days. Results: The values of CSF pressure at T1 and T5 were not significantly different in the two groups, but at T2, T3 and T4, they were significantly higher in the LiquoGuard group (T2: 13±6.6; T3: 12±4.9; T4: 11±4.3 cmH 2 O; p¼0.02, p¼0.03, p¼0.03, respectively). No difference was observed in connection with ischemia of the spinal- cord, intracranial hemorrhage and mortality. A significant reduction (2.3% vs 16.3%; p0.04) of post lumbar puncture headache was observed in the LiquoGuard group. Conclusion: The preoperative use of LiquoGuard during open surgery for TAA was sure and effective. In spite of peroperative CSF pressures slightly increased, the rates of ischemia of the spinal-cord did not increase in the Liquo- Guard group whereas post lumbar puncture headache was significantly reduced. http://dx.doi.org/10.1016/j.avsg.2015.06.019 Hybrid Treatment of Aortic Arch Aneurysms Associated with an Aneurysm of the Proximal Descending Thoracic Aorta: Early results of the Endovascular Second Stage of the Proximal Elephant Trunks Julien Gaudric, Clemence Jouhannet, Theresa Khalife, Marc Dennery, Nicolas Kagan, Laurent Chiche, and Fabien Koskas Service de chirurgie vasculaire, CHU Piti  e-Salp ^ etri  ere, Paris, France. Objectives: Aneurysms of the aortic arch prolonged by an aneurysm of the proximal thoracic aorta usually require a two-stage surgery. It comprises the realization 1050 30th Annual Meeting, French Society for Vascular Surgery (SCV), Montpellier, France, June 27-29, 2015 Annals of Vascular Surgery