Hatano R, Tsukuura T, Sunamori M, Iwai T, Yamamoto N, Yamada T, Asano K, Konno S
Jpn J Surg. 1978 Jun;8(2):93-101. doi: 10.1007/BF02469364.
From 1974 to 1976, four patients with juxtarenal aortic occlusion were operated upon with no surgical mortality. Thromboendarterectomy (TEA) of the aorta with renal revascularization was performed in one patient, and TEA with grafting in three. Intraoperative renal protection was particularly important, since suprarenal aortic clamping was often required in these cases. Possible renal embolism developed in one patient postoperatively. In order to prevent renal embolism and to minimize ischemic insult to the kidney, the value of the following procedures was stressed; (a) irrigation of aortic lumen with saline after TEA under suprarenal aortic clamping with renal arteries kept occluded, and (b) re-application of aortic clamp below the renal arteries after irrigation. Since the most distal level of occlusive process was the common femoral artery in our series, the patient with this disease entity should be treated more actively.
1974年至1976年期间，对4例肾旁主动脉闭塞患者进行了手术，无手术死亡病例。1例患者行主动脉血栓内膜切除术（TEA）并进行肾血管重建，3例患者行TEA并植入移植物。术中肾脏保护尤为重要，因为这些病例常需要进行肾上主动脉钳夹。1例患者术后发生了可能的肾栓塞。为预防肾栓塞并将对肾脏的缺血性损伤降至最低，强调了以下操作的价值：（a）在肾上主动脉钳夹且肾动脉保持闭塞的情况下，TEA术后用生理盐水冲洗主动脉腔；（b）冲洗后在肾动脉下方重新应用主动脉钳夹。由于在我们的系列病例中闭塞过程的最远端是股总动脉，因此对于患有这种疾病的患者应采取更积极的治疗措施。
