Surgical treatment of patients with renovascular hypertension secondary to aneurysmal lesions of the renal arteries.
The paper analyzes the results of examination and surgical treatment of 71 patients with renal artery (RA) aneurysms which constituted 3% among all the subjects treated and examined at the Russian Scientific Centre of Surgery, Russian Academy of Medical Sciences (RSCS RAMS). Fibromuscular dysplasia caused RA aneurysm most frequently (60%). Contrast radioangiography was the basic modality used in the diagnosis of RA aneurysms. While making decision as to whether the surgical treatment is feasible, preference was given to reconstructions on the renal arteries in order to reduce systemic arterial pressure and to maintain renal function. Resection of the aneurysmal renal artery was resorted to most frequently, followed by establishment of an end-to-end anastomosis (38.2%). Lateral resection of RA aneurysm was employed only in the event of its eccentric bulging and when its diameter did not exceed 15-20 mm (22.1 %). There were no lethal outcomes. The positive results could be obtained in 93.6% of patients. In the long-term postoperative period, the stable positive results were recorded in 60.9% of patients with a history of reconstructions on the renal arteries for their aneurysmal lesion.
Belov
Iu V
IuV
Russian Scientific Centre of Surgery, Moscow, Russia.
Kosenkov
A N
AN
Stepanenko
A B
AB
D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical; D001164:Arteriovenous Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods