title: Inferior mesenteric to renal artery transposition for revascularization of a solitary functioning kidney.
abstract: The aim of this article is to describe a new open surgical technique for revascularization of renal arteries. Several interventions for surgical revascularization of renal arteries have been proposed. We suggest to perform an alternative technique if the described inflow vessels are not suitable because of severe atherosclerosis or calcifications. A 76-year-old woman with a solitary functioning kidney and a subocclusive renal artery stenosis presented at our institution with renovascular hypertension and chronic kidney disease. After a failed percutaneous renal angioplasty attempt, we successfully treated the patient with an end-to-end inferior mesenteric to renal artery transposition. Other described techniques for revascularization of renal arteries were not suitable in this case, as commonly used inflow vessels were severely calcified. Although further studies are needed to better investigate the safety and effectiveness, this technique is simple and affordable, and it could be considered a valid alternative approach in selected patients, if other proposed interventions are not feasible. To the best of our knowledge, this is the first reported case with this kind of surgical reconstruction.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Ospedale Maggiore Policlinico, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, University of Milan, Milan, Italy. Electronic address: michele.silvestro@icloud.com.
authors.forename: Michele
authors.initials: M
authors.lastname: Silvestro
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Ospedale Maggiore Policlinico, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, University of Milan, Milan, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Domanin
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Ospedale Maggiore Policlinico, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, University of Milan, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Floriani
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Ospedale Maggiore Policlinico, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda, University of Milan, Milan, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Gabrielli
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D015901:Angiography, Digital Subtraction; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017537:Mesenteric Artery, Inferior / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency