Vogt P A, Pairolero P C, Hollier L H, Fowl R J, Cherry K J, Bernatz P E
J Vasc Surg. 1985 Jan;2(1):125-32. doi: 10.1067/mva.1985.avs0020125.
Between 1970 and 1982, 50 patients (38 male and 12 female) underwent revascularization of 51 occluded renal arteries. Ages ranged from 8 to 71 years (mean 54.6 years). Occlusion was caused by atherosclerosis in 43 patients, fibromuscular dysplasia in three, chronic dissection in two, abdominal aortic coarctation in one, and neurofibromatosis in one. Contralateral renal artery occlusive disease occurred in 22 patients. Extrarenal atherosclerosis occurred in 44 patients. Mean preoperative serum creatinine level ranged from 0.5 to 8.4 mg/dl (mean 1.9 mg/dl). No patient required preoperative dialysis. Length of the involved kidney ranged from 8.4 to 14.5 cm (mean 11.5 cm). Indication for renal revascularization was hypertension in 49 patients and preservation of renal function in one. Renal artery bypass was performed in 36 patients, renal artery endarterectomy in six, transaortic endarterectomy in five, and reimplantation of the renal artery in three. Simultaneous revascularization of the contralateral renal artery was performed in 20 patients. There were three operative deaths. At hospital dismissal, hypertension had improved in 45 of 46 patients. Follow-up periods ranged from 4 months to 12 years (mean 50.2 months). Thirty-four patients remained normotensive, five still had less hypertension, and seven became worse. These data demonstrate that revascularization of an occluded renal artery can be effective in controlling hypertension and that this effect is durable in the majority of patients.
1970年至1982年间，50例患者（38例男性，12例女性）接受了51条闭塞肾动脉的血管重建术。年龄范围为8至71岁（平均54.6岁）。43例患者的闭塞由动脉粥样硬化引起，3例由纤维肌性发育异常引起，2例由慢性夹层形成引起，1例由腹主动脉缩窄引起，1例由神经纤维瘤病引起。22例患者出现对侧肾动脉闭塞性疾病。44例患者存在肾外动脉粥样硬化。术前血清肌酐水平范围为0.5至8.4mg/dl（平均1.9mg/dl）。无患者需要术前透析。患侧肾脏长度范围为8.4至14.5cm（平均11.5cm）。肾血管重建的指征为49例患者的高血压和1例患者的肾功能保留。36例患者进行了肾动脉旁路移植术，6例进行了肾动脉内膜切除术，5例进行了经主动脉内膜切除术，3例进行了肾动脉再植术。20例患者同时进行了对侧肾动脉血管重建。有3例手术死亡。出院时，46例患者中的45例高血压得到改善。随访期为4个月至12年（平均50.2个月）。34例患者血压保持正常，5例仍有轻度高血压，7例病情恶化。这些数据表明，闭塞肾动脉的血管重建术可有效控制高血压，且这种效果在大多数患者中是持久的。
