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December 1980, Vol 115, No. 12 >
ARTICLE | December 1980

Simultaneous Aortic and Renal Artery Reconstruction FREE

David M. Shahian, MD; Hassan Najafi, MD; Hushang Javid, MD, PhD; James A. Hunter, MD; Marshall D. Goldin, MD; David O. Monson, MD
[+] Author Affiliations

Accepted for publication May 16, 1980.

Reprint requests to Rush-Presbyterian-St Luke's Medical Center, 1725 W Congress Pkwy, Chicago, IL 60612 (Dr Najafi).


Arch Surg. 1980;115(12):1491-1497. doi:10.1001/archsurg.1980.01380120059014
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References
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• From 1970 to 1978, 39 patients underwent simultaneous aortic and renal artery reconstruction. Of these, 37 had severe single or bilateral renal lesions in combination with an aortic aneurysm, or symptomatic or asymptomatic aortoiliac disease. Two patients had renal arteries that originated from an abdominal arotic aneurysm. Thirty-two patients were hypertensive, one had chronic renal failure, and three others had asymptomatic renal lesions that were bypassed prophylactically. Operations performed included aortic replacement plus: single renal graft; bilateral renal grafts; renal graft plus contralateral nephrectomy; and renal graft plus mesenteric revascularization. All early postoperative deaths (four) occurred in patients with aneurysmal disease. Twenty-nine patients were available for long-term evaluation. In patients who were hypertensive preoperatively, 64.0% experienced long-term cure or improvement. Cardiac and cerebral disease, lower extremity claudication, and the need for subsequent cardiovascular surgery occurred with substantial frequency during the follow-up period.

(Arch Surg 115:1491-1497, 1980)

REFERENCES

1 +
DeBakey ME, Morris GC, Morgen RO, et al:  Lesions of the renal artery . Am J Surg 107:84-96, 1964;.
2 +
Foster JH, Dean RH, Pinkerton JA, et al:  Ten year experience with surgical management of renovascular hypertension . Ann Surg 177:755-766, 1973;.
3 +
Foster JH, Maxwell MH, Franklin SS, et al:  Renovascular occlusive disease . JAMA 231:1043-1048, 1975;.
4 +
Morris GC, DeBakey ME, Crawford ES, et al:  Late results of surgical treatment for renovascular hypertension . Surg Gynecol Obstet 122:1255-1261, 1966;.
5 +
Stanley JC, Fry WJ:  Surgical treatment of renovascular hypertension . Arch Surg 112:1291-1297, 1977;.
6 +
Brewster DC, Retana A, Waltman AC, et al:  Angiography in the management of aneurysms of the abdominal aorta . N Engl J Med 292:822-825, 1975;.
7 +
Bauer GM, Porter JM, Eidemiller LR, et al:  The role of arteriography in abdominal aortic aneurysm . Am J Surg 136:184-189, 1978;.
8 +
Van Velzer DA, Burge CH, Morris GC Jr:  Arteriosclerotic narrowing of renal arteries associated with hypertension . AJR 86:807-818, 1961;.
9 +
Holley KE, Hunt JC, Brown AL, et al:  Renal artery stenosis . Am J Med 37:14-22, 1964;.
10 +
Eyler WR, Clark MD, Garman JE, et al:  Angiography of the renal areas including a comparative study of renal arterial stenosis in patients with and without hypertension . Radiology 78:879-891, 1962;.
11 +
Dustan HP, Humphries AW, deWolfe VG, et al:  Normal arterial pressure in patients with renal arterial stenosis . JAMA 187:1028-1029, 1964;.
12 +
Franklin SS, Young JD, Maxwell MH, et al:  Operative morbidity and mortality in renovascular disease . JAMA 231:1148-1153, 1975;.
13 +
Ernst CB, Stanley JC, Marshall FF, et al:  Renal revascularization for arteriosclerotic renovascular hypertension: Prognostic implications of focal renal arterial vs overt generalized arteriosclerosis . Surgery 73:859-867, 1973;.
14 +
Brewster DC, Buth J, Darling RC, et al:  Combined aortic and renal artery reconstruction . Am J Surg 131:457-463, 1976;.
15 +
Gomes MMR, Bernatz PE:  Aorto-iliac occlusive disease . Arch Surg 101:161-166, 1970;.
16 +
Ernst CB, Bookstein JJ, Montie J, et al:  Renal vein renin ratios and collateral vessels in renovascular hypertension . Arch Surg 104:496-502, 1972;.
17 +
Dean RH, Oates JA, Wilson JP, et al:  Bilateral renal artery stenosis and renovascular hypertension . Surgery 81:53-62, 1977;.
18 +
Couch NP, Sullivan J, Crane C:  The predictive accuracy of renal vein renin activity in the surgery of renovascular hypertension . Surgery 79:70-76, 1976;.
19 +
Maxwell MH, Marks LS, Lupu AN, et al:  Predictive value of renin determinations in renal artery stenosis . JAMA 238:2617-2620, 1977;.
20 +
Buda JA, Baer L, Parra-Carrillo JZ, et al:  Predictability of surgical response in renovascular hypertension . Arch Surg 111:1243-1248, 1976;.
21 +
Wylie EJ, Perloff DL, Stoney RJ:  Autogenous tissue revascularization technics in surgery for renovascular hypertension . Ann Surg 170:416-428, 1969;.
22 +
Corman JL, Anderson JT, Taubman J, et al:  Ex vivo perfusion, arteriography and autotransplantation procedure for kidney salvage . Surg Gynecol Obstet 137:659-665, 1973;.
23 +
Novick AC, Banowsky LHW, Stewart BH, et al:  Renal revascularization in patients with severe atherosclerosis of the abdominal aorta or a previous operation on the abdominal aorta . Surg Gynecol Obstet 144:211-218, 1977;.
24 +
Hurwitt ES, Seidenberg B, Haimovici H, et al:  Splenorenal arterial anastomosis . Circulation 14:532-539, 1956;.
25 +
Brewster DC, Darling RC:  Splenorenal arterial anastomosis for renovascular hypertension . Ann Surg 189:353-358, 1979;.
26 +
Novick AC, Banowsky LHW, Stewart BH, et al:  Splenorenal bypass in the treatment of stenosis of the renal artery . Surg Gynecol Obstet 144:891-898, 1977;.
27 +
Novick AC, Palleschi J, Straffon RA, et al:  Experimental and clinical hepatorenal bypass as a means of revascularization of the right renal artery . Surg Gynecol Obstet . 148:557-561, 1979;.
28 +
Libertino JA, Zinman L, Breslin DJ, et al:  Hepatorenal artery bypass in the management of renovascular hypertension . J Urol 115:369-372, 1976;.

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1 +
DeBakey ME, Morris GC, Morgen RO, et al:  Lesions of the renal artery . Am J Surg 107:84-96, 1964;.
2 +
Foster JH, Dean RH, Pinkerton JA, et al:  Ten year experience with surgical management of renovascular hypertension . Ann Surg 177:755-766, 1973;.
3 +
Foster JH, Maxwell MH, Franklin SS, et al:  Renovascular occlusive disease . JAMA 231:1043-1048, 1975;.
4 +
Morris GC, DeBakey ME, Crawford ES, et al:  Late results of surgical treatment for renovascular hypertension . Surg Gynecol Obstet 122:1255-1261, 1966;.
5 +
Stanley JC, Fry WJ:  Surgical treatment of renovascular hypertension . Arch Surg 112:1291-1297, 1977;.
6 +
Brewster DC, Retana A, Waltman AC, et al:  Angiography in the management of aneurysms of the abdominal aorta . N Engl J Med 292:822-825, 1975;.
7 +
Bauer GM, Porter JM, Eidemiller LR, et al:  The role of arteriography in abdominal aortic aneurysm . Am J Surg 136:184-189, 1978;.
8 +
Van Velzer DA, Burge CH, Morris GC Jr:  Arteriosclerotic narrowing of renal arteries associated with hypertension . AJR 86:807-818, 1961;.
9 +
Holley KE, Hunt JC, Brown AL, et al:  Renal artery stenosis . Am J Med 37:14-22, 1964;.
10 +
Eyler WR, Clark MD, Garman JE, et al:  Angiography of the renal areas including a comparative study of renal arterial stenosis in patients with and without hypertension . Radiology 78:879-891, 1962;.
11 +
Dustan HP, Humphries AW, deWolfe VG, et al:  Normal arterial pressure in patients with renal arterial stenosis . JAMA 187:1028-1029, 1964;.
12 +
Franklin SS, Young JD, Maxwell MH, et al:  Operative morbidity and mortality in renovascular disease . JAMA 231:1148-1153, 1975;.
13 +
Ernst CB, Stanley JC, Marshall FF, et al:  Renal revascularization for arteriosclerotic renovascular hypertension: Prognostic implications of focal renal arterial vs overt generalized arteriosclerosis . Surgery 73:859-867, 1973;.
14 +
Brewster DC, Buth J, Darling RC, et al:  Combined aortic and renal artery reconstruction . Am J Surg 131:457-463, 1976;.
15 +
Gomes MMR, Bernatz PE:  Aorto-iliac occlusive disease . Arch Surg 101:161-166, 1970;.
16 +
Ernst CB, Bookstein JJ, Montie J, et al:  Renal vein renin ratios and collateral vessels in renovascular hypertension . Arch Surg 104:496-502, 1972;.
17 +
Dean RH, Oates JA, Wilson JP, et al:  Bilateral renal artery stenosis and renovascular hypertension . Surgery 81:53-62, 1977;.
18 +
Couch NP, Sullivan J, Crane C:  The predictive accuracy of renal vein renin activity in the surgery of renovascular hypertension . Surgery 79:70-76, 1976;.
19 +
Maxwell MH, Marks LS, Lupu AN, et al:  Predictive value of renin determinations in renal artery stenosis . JAMA 238:2617-2620, 1977;.
20 +
Buda JA, Baer L, Parra-Carrillo JZ, et al:  Predictability of surgical response in renovascular hypertension . Arch Surg 111:1243-1248, 1976;.
21 +
Wylie EJ, Perloff DL, Stoney RJ:  Autogenous tissue revascularization technics in surgery for renovascular hypertension . Ann Surg 170:416-428, 1969;.
22 +
Corman JL, Anderson JT, Taubman J, et al:  Ex vivo perfusion, arteriography and autotransplantation procedure for kidney salvage . Surg Gynecol Obstet 137:659-665, 1973;.
23 +
Novick AC, Banowsky LHW, Stewart BH, et al:  Renal revascularization in patients with severe atherosclerosis of the abdominal aorta or a previous operation on the abdominal aorta . Surg Gynecol Obstet 144:211-218, 1977;.
24 +
Hurwitt ES, Seidenberg B, Haimovici H, et al:  Splenorenal arterial anastomosis . Circulation 14:532-539, 1956;.
25 +
Brewster DC, Darling RC:  Splenorenal arterial anastomosis for renovascular hypertension . Ann Surg 189:353-358, 1979;.
26 +
Novick AC, Banowsky LHW, Stewart BH, et al:  Splenorenal bypass in the treatment of stenosis of the renal artery . Surg Gynecol Obstet 144:891-898, 1977;.
27 +
Novick AC, Palleschi J, Straffon RA, et al:  Experimental and clinical hepatorenal bypass as a means of revascularization of the right renal artery . Surg Gynecol Obstet . 148:557-561, 1979;.
28 +
Libertino JA, Zinman L, Breslin DJ, et al:  Hepatorenal artery bypass in the management of renovascular hypertension . J Urol 115:369-372, 1976;.

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