Pedro Bonamigo Telmo, Luis Lucas Márcio
Fundação Faculdade Federal de Ciencias Médicas de Porto Alegre, Serviço de Cirurgia Vascular, Pavilhão Pereira Filho e Hospital São Francisco da Santa Casa de Porto Alegre, Brasil.
Rev Port Cir Cardiotorac Vasc. 2007 Apr-Jun;14(2):87-91.
Stenosis of the renal artery is frequent in patients with atherosclerotic aortic disease.
To evaluate the surgical results of renal revascularization concomitant to the abdominal aortic aneurysm (AAA) repair.
Between April 1986 and August 2006, 783 patients were submitted to the infrarenal AAA elective repair by the first author. Of these, 24 patients (3%) were submitted to concomitant renal revascularization to the AAA repair. We analysed the demographics, surgical data and the survival through the long term results.
Sixteen patients were male (66,7%), with average age of 69,4 + 6,4 years (range, 54 to 78 years), with the majority hypertensive (62,5%) and smokers (54,2%). Nine patients (37,5%) had previous renal insufficiency (creatinine levels > 2mg/dL). Surgical indication was due to aortic aneurismatic disease in all cases. The renal procedures were unilateral in 18 patients (75%) and bilateral in 6 (25%). Occurred two deaths (8,3%) and morbidity of 25% (6/24). The mean of survival time was 53 +/- months and the estimated 5 year survival was 41,7%.
In our study, renal revascularization concomitant to AAA repair revealed acceptable mortality (8,3%), despite the high risk of our patients (previous renal dysfunction). Furthermore, the long term survival in our patients was comparable to that of patients with renal insufficiency submitted to AAA repair.
肾动脉狭窄在患有动脉粥样硬化性主动脉疾病的患者中很常见。
评估与腹主动脉瘤（AAA）修复同时进行的肾血管重建手术的结果。
1986年4月至2006年8月期间，第一作者对783例患者进行了肾下AAA择期修复。其中，24例患者（3%）在AAA修复的同时进行了肾血管重建。我们分析了人口统计学、手术数据以及长期结果的生存率。
16例患者为男性（66.7%），平均年龄为69.4±6.4岁（范围为54至78岁），大多数患者患有高血压（62.5%）且吸烟（54.2%）。9例患者（37.5%）既往有肾功能不全（肌酐水平>2mg/dL）。所有病例的手术指征均为主动脉瘤疾病。18例患者（75%）的肾脏手术为单侧，6例（25%）为双侧。发生2例死亡（8.3%），发病率为25%（6/24）。平均生存时间为53±个月，估计5年生存率为41.7%。
在我们的研究中，尽管患者风险较高（既往肾功能不全），但与AAA修复同时进行的肾血管重建显示出可接受的死亡率（8.3%）。此外，我们患者的长期生存率与接受AAA修复的肾功能不全患者相当。
