Michel J B, Nussaume O, Valverde J P, Cohen G, Duchatelle J P, Andreassian B, Moulonguet-Doloris J L
J Mal Vasc. 1985;10(3):221-6.
Late renal revascularization could be indicated in totally occluded renal artery with hypertension and or renal insufficiency. Six cases of secondary revascularization after occlusion of renal artery are reported here. In three cases severe renovascular hypertension was the indication for renal revascularization. In three other cases, indication was proposed for renal insufficiency. In four cases, renal revascularization for totally occluded renal artery have been beneficial for the patients. In two cases of terminal renal insufficiency, chronical hemodialysis could be suppressed. In the others two cases, hypertension was clearly improved. The criteria for renal revascularization before and during surgery are discussed here. The kidney length, the cortico-medullary ratio at kidney echography, and the visualization of a nephrography during angiography are the principal criteria before surgery for renal revascularization. The macroscopic aspect of the kidney, the immediate results of renal biopsy and the importance of a blood reflow in the renal artery are the principal criteria during surgery, but must be discussed because there are no definitive criteria. Renal revascularization shall be proposed when totally occluded renal artery is associated with renal insufficiency and/or hypertension, especially when the other side can be affected by the same disease.
晚期肾血管重建术适用于肾动脉完全闭塞并伴有高血压和/或肾功能不全的情况。本文报告了6例肾动脉闭塞后继发性血管重建术的病例。其中3例因严重肾血管性高血压而进行肾血管重建术。另外3例的指征是肾功能不全。4例肾动脉完全闭塞患者接受肾血管重建术后病情得到改善。2例终末期肾功能不全患者能够停止长期血液透析。另外2例患者的高血压明显改善。本文讨论了手术前后肾血管重建术的标准。肾长度、肾脏超声检查时的皮质髓质比以及血管造影时肾造影的显影情况是术前肾血管重建术的主要标准。肾脏的宏观外观、肾活检的即时结果以及肾动脉血流再通的重要性是手术中的主要标准，但由于没有明确的标准，仍需进一步探讨。当肾动脉完全闭塞伴有肾功能不全和/或高血压时，尤其是对侧肾脏可能受到同一疾病影响时，应考虑进行肾血管重建术。
