Soussou I D, Starr D S, Lawrie G M, Morris G C
Arch Surg. 1979 Dec;114(12):1410-5. doi: 10.1001/archsurg.1979.01370360064007.
Renal artery aneurysm is an uncommon cause of renovascular hypertension. Nephrectomy or, more recently ex vivo arterial reconstruction have been recommended as the treatment of choice. In contrast, we advocate in situ repair of the aneurysm and any associated lesions. Twenty-five hypertensive patients with 30 renal artery aneurysms were treated by tangential aneurysmectomy with primary arteriorrhaphy, saphenous vein patch angioplasty, or bypass graft. Nephrectomy was performed in two patients, one for a ruptured aneurysm. There was no operative mortality. Follow-up was obtained on all patients six months to 19 years after operation. Hypertension was relieved immediately and in the long-term in the majority of survivors. We believe these results indicate that despite the presence of severe renovascular disease, the affected kidney can be preserved and hypertension successfully relieved by a direct surgical approach without recourse to either nephrectomy or ex vivo reconstruction.
肾动脉动脉瘤是肾血管性高血压的一种罕见病因。肾切除术或更近一些的体外动脉重建术已被推荐为首选治疗方法。相比之下，我们主张对动脉瘤及任何相关病变进行原位修复。25例患有30个肾动脉动脉瘤的高血压患者接受了切线状动脉瘤切除术，并行一期动脉缝合、大隐静脉补片血管成形术或旁路移植术。两名患者接受了肾切除术，其中一名是因为动脉瘤破裂。无手术死亡病例。对所有患者在术后6个月至19年进行了随访。大多数幸存者的高血压立即得到缓解且长期保持缓解状态。我们认为，这些结果表明，尽管存在严重的肾血管疾病，但通过直接手术方法，无需进行肾切除术或体外重建术，即可保留患肾并成功缓解高血压。
