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Aortic and renal atherosclerotic disease
Surgery, Gynecology & Obstetrics
|July 1, 1986
Summary
Simultaneous aortic and renal revascularization can yield good results for hypertension and renal function. However, high operative risks suggest a conservative approach for high-risk patients or those with asymptomatic renal artery stenosis.
Area of Science:
- Vascular Surgery
- Nephrology
- Cardiovascular Medicine
Background:
- Simultaneous aortic and renal revascularization addresses complex cardiovascular and renal conditions.
- Hypertension and renal artery disease often coexist, necessitating combined surgical approaches.
Purpose of the Study:
- To evaluate outcomes of simultaneous aortic and renal revascularization.
- To assess the impact of treating clinically silent renal artery lesions during aortic reconstruction.
Main Methods:
- Retrospective review of 39 patients undergoing simultaneous aortic and renal revascularization (1972-1985).
- Analysis of 133 patients with aortic reconstruction and untreated renal artery lesions.
- Follow-up assessment of mortality, hypertension control, and renal function.
Main Results:
- Operative mortality for simultaneous revascularization was 10%.
- 65.6% of hypertensive patients showed improvement or cure.
- Nine of 13 patients with preoperative renal dysfunction improved post-surgery.
- Five patients had early renal failure after aortic reconstruction without renal revascularization.
- Late renal failure occurred in 3 of 126 survivors; 18 remained hypertensive.
Conclusions:
- Simultaneous aortic and renal revascularization offers respectable outcomes for selected patients.
- A conservative strategy is advised for high-risk individuals or those with asymptomatic renal artery stenosis due to increased operative risks.