Dubernard J M, Martin X, Gelet A, Mongin D
Eur Urol. 1985;11(1):26-30. doi: 10.1159/000472444.
27 patients underwent surgical arterial reconstruction for renal artery aneurysms. Hypertension was present in 21 cases. The indication for surgery was the prevention of hemorrhagic rupture in association with hypertension. Extracorporeal surgery was performed 13 times for complex aneurysms involving several branches of the renal artery. Simple autotransplantation was performed 3 times for aneurysms located on the main renal artery. In situ surgery was performed on 11 patients (5 aneurysmectomy-arteriorrhaphies and 7 bypass operations). Results on high blood pressure showed that 10 of the 14 hypertensive patients operated by extracorporeal surgery and/or autotransplantation were cured. 1 delayed nephrectomy was performed in this group and 1 death was observed. 39 of the 46 peripheral anastomoses were patent postoperatively. All patients treated with aneurysmectomy-arteriorrhaphy were cured. In patients treated with bypass operations, 3 thromboses of the bypass and 2 failures on hypertension were observed. Aneurysmectomy and simple arterioplasty are preferred for simple renal artery aneurysms. For complex lesions involving several branches and of an intrarenal location, extracorporeal surgery and autotransplantation represent an effective treatment on hypertension and preservation of kidney function.
27例患者接受了肾动脉动脉瘤的外科动脉重建术。21例存在高血压。手术指征是预防与高血压相关的出血性破裂。对于累及肾动脉多个分支的复杂动脉瘤，进行了13次体外手术。对于位于肾动脉主干上的动脉瘤，进行了3次单纯自体肾移植。11例患者进行了原位手术（5例动脉瘤切除术 - 动脉缝合术和7例旁路手术）。高血压治疗结果显示，14例接受体外手术和/或自体肾移植的高血压患者中有10例治愈。该组进行了1例延迟肾切除术，观察到1例死亡。46例周围吻合口中有39例术后通畅。所有接受动脉瘤切除术 - 动脉缝合术治疗的患者均治愈。在接受旁路手术治疗的患者中，观察到3例旁路血栓形成和2例高血压治疗失败。对于单纯性肾动脉动脉瘤，动脉瘤切除术和单纯动脉成形术是首选。对于累及多个分支且位于肾内的复杂病变，体外手术和自体肾移植是治疗高血压和保留肾功能的有效方法。
