Renal revascularization by end-to-end anastomosis of the hepatic and renal arteries.
From June 1981 to January 1984, 13 patients with atherosclerotic renal artery disease underwent revascularization by end-to-end anastomosis of the hepatic and renal arteries. Renal revascularization was indicated to preserve renal function and/or to treat associated hypertension. An aortorenal bypass was not possible owing to severe aortic atherosclerosis or a prior aortic operation. Right renal revascularization was performed by end-to-end anastomosis of the renal artery to the common hepatic artery in 7 patients, right hepatic artery in 4, left hepatic artery in 1 or gastroduodenal artery in 1. Postoperatively, 2 patients suffered a necrotic gallbladder owing to ischemia and 1 of these patients died. Liver enzymes were elevated immediately postoperatively in 11 patients but returned to normal within 2 weeks in each case. Currently, all 12 surviving patients have normal liver function, well controlled blood pressure and improved renal function. End-to-end anastomosis of the hepatic and renal arteries is an effective method of revascularization but specific measures must be taken to avoid complications of gallbladder ischemia.
D000368:Aged; D001161:Arteriosclerosis / Q000150:complications / Q000601:surgery*; D005260:Female; D005704:Gallbladder / Q000098:blood supply; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology; D007511:Ischemia / Q000209:etiology; D007668:Kidney / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012077:Renal Artery / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000209:etiology / Q000601:surgery*