Stoney R J, Skiöldebrand C G, Qvarfordt P G, Reilly L M, Ehrenfeld W K
Ann Surg. 1984 Sep;200(3):345-54. doi: 10.1097/00000658-198409000-00012.
Ninety patients underwent combined aortic (90) and renal artery (138 arteries) reconstruction for severe, symptomatic aortic occlusive disease (47 patients), aortic aneurysmal disease (30 patients), and visceral atherosclerosis (13 patients). Transaortic endarterectomy was used for 67% of renal artery reconstructions and 69% of visceral arteries. Aortic reconstruction required prosthetic grafting in 74%. A standard transabdominal approach was used in 72 of 90 patients (80%), and thoraco-retroperitoneal exposure was necessary in 18 patients. Perioperative mortality was 9% (8/90) and morbidity 16% (14/90). Ninety per cent of the patients were evaluated at long-term (mean 32 months). Hypertension was cured or improved at discharge in 82% (59/72), and in 96% hypertension improvement was sustained during the follow-up interval. Renal function was improved or preserved in 93% (40/43) at discharge, and this response was sustained in 84% during the follow-up period. Late mortality (8/74, 11%) was lower than expected and is attributed to the technique of combined repair, the cure and control of hypertension, the prevention of ongoing renal ischemia, and the preservation of renal function.
90例患者因严重的有症状的主动脉闭塞性疾病（47例）、主动脉瘤样疾病（30例）和内脏动脉粥样硬化（13例）接受了主动脉（90例）和肾动脉（138条动脉）联合重建术。67%的肾动脉重建和69%的内脏动脉重建采用经主动脉内膜切除术。74%的主动脉重建需要使用人工血管移植。90例患者中有72例（80%）采用标准经腹入路，18例患者需要胸腹联合腹膜后暴露。围手术期死亡率为9%（8/90），发病率为16%（14/90）。90%的患者接受了长期评估（平均32个月）。82%（59/72）的患者出院时高血压得到治愈或改善，96%的患者在随访期间高血压持续改善。43例患者中有93%（40/43）出院时肾功能得到改善或维持，84%的患者在随访期间维持了这种反应。晚期死亡率（8/74，11%）低于预期，这归因于联合修复技术、高血压的治愈和控制、持续肾缺血的预防以及肾功能的维持。
