Surgery for obstructive lesions of the main trunk of the renal artery. A review of the literature and personal experience of 41 operated patients.
Today, surgical revascularization of the renal artery seems to maintain interest in the therapy of renovascular hypertension and chronic ischemic nephropathy because both medical therapy and angioplasty show limits and inconveniences. The authors present here their experience of 45 revascularized renal arteries in 41 patients and they discuss early and late morphological and functional results related to isolated arterial renal pathology (Group 1 of 23 patients) and associated to aorto-iliac pathology (Group 2 of 18 patients). Mortality related to arterial renal reconstruction was nil. There were 3/45 arteries (6.6%) with early thromboses and 4/32 (9.3%) with late thromboses. Early functional results, with respect to renovascular hypertension and/or chronic ischaemic renal insufficiency, showed 16/41 (39%) healed patients, 16/41 (39%) improved patients and 9/41 (22%) unvariated patients. Late results among 28 observed patients (average follow up at 49 months, range from 18 to 144 months) showed 14/28 (50%) healed patients, 11/28 (39%) improved patients and 3/28 (11%) unvariated patients. Results of the Group I were significantly better than results of Group 2 with regards to healed patients (p < 0.01) but not summarizing healed and improved cases. These data have been discussed in comparison with the Literature review of 46 references.
Giulini
S M
SM
Chair of General Surgery I, University of Brescia, Italy.
Bonardelli
S
S
Cangiotti
L
L
Nodari
F
F
Benzi
F
F
Portolani
N
N
Tiberio
G A
GA
Coniglio
A
A
Tiberio
G
G
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000601:surgery*; D013997:Time Factors