Document Detail

Long-term effectiveness of extraanatomic renal artery revascularization.
MedLine Citation:
PMID:  7940179     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The efficacy of direct aortorenal bypass and renal artery endarterectomy are well established. The purpose of this study is to define better the results of extraanatomic renal revascularization procedures. METHODS: From April 1987 to March 1993, 124 patients underwent renal artery revascularization. Forty-eight (39%) of them (33 women, 15 men; average age, 65.9 years) underwent 49 extraanatomic renal artery bypasses. Preoperative risk factors included smoking in 30 patients (61%), history of myocardial infarction in 14 (29%), diabetes mellitus in 11 (22%), congestive heart failure in nine (18%), chronic obstructive pulmonary disease in 11 (22%), and stroke in six (12%). The average creatinine level was 2.3 mg/dl. The average number of antihypertensive medications was 2.4. Thirty iliorenal, 10 gastroduodenal-renal, seven hepatorenal, and two splenorenal bypasses were performed together with 10 contralateral nephrectomies. RESULTS: Six major postoperative complications occurred. There were no deaths. Forty-one (85%) of patients had improvement or cure of their hypertension. Seven (15%) of patients failed to respond to treatment, and three required subsequent nephrectomy. After operation the average creatinine level was 1.7 mg/dl and the average number of medications was 1.7. Mean follow-up period has been 23.2 months (range, 1 to 79 months). CONCLUSIONS: Extraanatomic bypass proved to be efficacious in treating hypertension and preserving renal function and has an acceptable rate of morbidity and mortality. We conclude that these procedures are an acceptable alternative to direct aortorenal artery revascularization.
J M Reilly; B G Rubin; R W Thompson; B T Allen; C B Anderson; G A Sicard
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgery     Volume:  116     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1994-11-16     Completed Date:  1994-11-16     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  784-90; discussion 790-1     Citation Subset:  AIM; IM    
Department of Surgery, Washington University School of Medicine, St. Louis, Mo.
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MeSH Terms
Arteriosclerosis / complications
Hypertension / surgery
Kidney / physiopathology
Middle Aged
Postoperative Complications
Renal Artery / surgery*
Renal Artery Obstruction / etiology,  surgery

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