Belzer F O, Raczkowski A
Surgery. 1982 Oct;92(4):642-5.
Ex vivo artery reconstruction with autotransplantation was performed on 34 occasions in 33 patients over the past 10 years. The cause of the renal artery disease was fibromuscular disease in 26 patients, arteriosclerosis or reoperation in 5 patients, acute dissection of the thoracic and abdominal aorta in 1 patient, and renal artery aneurysm in a single kidney in 1 patient. All patients were thought to be inoperable by in situ reconstruction. Many patients were treated with a combination of methods including bilateral ex vivo reconstruction, unilateral in situ and contralateral ex vivo reconstruction, and unilateral ex vivo reconstruction with contralateral nephrectomy. Arterial autografts were used in all but one patient to replace the diseased segment of renal artery. Follow-up was from 6 months to 10 years. The following results were obtained. One patient died 7 days after surgery from a ruptured berry aneurysm, and one patient required nephrectomy 6 months after reconstruction because of restenosis. There was no morbidity in the remaining patients. Results in the remaining patients were as follows. Twenty patients were classified as having excellent results, seven patients good results, 2 patients fair results, and two patients poor results. Combining the excellent and good groups showed an 86% cure or considerable improvement rate. These results suggest that ex vivo renal artery reconstruction is an effective and safe method of treating renal vascular hypertension when indicated.
在过去10年中，对33例患者进行了34次自体移植的体外动脉重建手术。肾动脉疾病的病因在26例患者中为纤维肌性疾病，5例患者为动脉硬化或再次手术，1例患者为胸主动脉和腹主动脉急性夹层，1例患者为单肾肾动脉动脉瘤。所有患者均被认为无法通过原位重建进行手术。许多患者采用了多种方法联合治疗，包括双侧体外重建、单侧原位和对侧体外重建，以及单侧体外重建并对侧肾切除术。除1例患者外，所有患者均使用动脉自体移植物替代肾动脉病变段。随访时间为6个月至10年。获得了以下结果。1例患者术后7天因破裂的浆果状动脉瘤死亡，1例患者在重建后6个月因再狭窄需要肾切除术。其余患者无并发症发生。其余患者的结果如下。20例患者结果为优，7例患者结果为良，2例患者结果为中，2例患者结果为差。将优和良的组合并显示治愈率或显著改善率为86%。这些结果表明，体外肾动脉重建是一种在有指征时治疗肾血管性高血压的有效且安全的方法。
