Zhang Jason, Gaffey Ann C, Jackson Benjamin
Division of Vascular and Endovascular Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
J Vasc Surg Cases Innov Tech. 2021 Jan 28;7(1):113-116. doi: 10.1016/j.jvscit.2020.12.013. eCollection 2021 Mar.
In the present case report, we have described a patient with bilateral renal artery occlusion resulting in the acute onset of refractory hypertension and renal failure requiring hemodialysis. Endovascular stenting of the renal arteries was not feasible owing to extensive aortic and renal orifice calcification. After consultation with nephrology and medical optimization, the patient underwent unilateral hepatorenal bypass, with subsequent improvement in renal function and sustained freedom from dialysis. Although percutaneous revascularization has become the preferred option for surgical management of renal artery occlusion, the findings from the present case have demonstrated that hepatorenal bypass remains a viable alternative for more complex cases.
在本病例报告中，我们描述了一名双侧肾动脉闭塞的患者，该患者急性起病，出现难治性高血压和需要血液透析的肾衰竭。由于广泛的主动脉和肾动脉开口钙化，肾动脉血管内支架置入术不可行。在咨询肾病科并进行医学优化后，该患者接受了单侧肝肾旁路手术，随后肾功能得到改善，且持续无需透析。尽管经皮血管重建术已成为肾动脉闭塞外科治疗的首选方案，但本病例的结果表明，对于更复杂的病例，肝肾旁路手术仍是一种可行的替代方案。
