Huffman A D, Johnson R C
Department of Surgery, Carraway Methodist Medical Center, Birmingham, Ala.
South Med J. 1988 Apr;81(4):440-3. doi: 10.1097/00007611-198804000-00007.
Renal artery reconstruction has traditionally been limited to cases of documented renal artery hypertension. We report our experience with renal artery reconstruction on 32 arteries in 23 patients over a three-year period. These procedures were done for renovascular hypertension in nine patients, for renal preservation in seven patients, and concomitantly with aortic reconstruction in seven patients. Aortorenal bypass was the primary method of reconstruction, with thromboendarterectomy, primary reanastomosis, and splenorenal bypass being used less frequently. Significant improvement in hypertension was seen in virtually all patients, with improvement in renal function seen in all patients operated on for threatened renal function. In no case did renal function deteriorate postoperatively, and there have been no operative deaths. Major complications included postoperative hemorrhage (four patients), myocardial infarction (one patient), and restenosis of an artery after previous thromboendarterectomy (one patient). Renal artery revascularization procedures are safe and useful in selected patients with hypertension and ischemic nephropathy.
传统上，肾动脉重建仅限于有记录的肾动脉高血压病例。我们报告了在三年时间里对23例患者的32条动脉进行肾动脉重建的经验。这些手术用于9例患者的肾血管性高血压、7例患者的肾脏保留，以及7例患者与主动脉重建同时进行。主动脉-肾动脉旁路移植术是主要的重建方法，血栓内膜切除术、一期再吻合术和脾-肾动脉旁路移植术使用较少。几乎所有患者的高血压都有显著改善，所有因肾功能受到威胁而接受手术的患者肾功能均有改善。术后肾功能无一例恶化，也无手术死亡病例。主要并发症包括术后出血（4例患者）、心肌梗死（1例患者）以及既往血栓内膜切除术后动脉再狭窄（1例患者）。肾动脉血运重建术在选定的高血压和缺血性肾病患者中是安全且有用的。
