Concomitant renal revascularization in patients undergoing aortic surgery.

Area of Science:

• Vascular Surgery
• Nephrology
• Cardiovascular Medicine

Background:

• Renal artery stenosis (RAS) often coexists with aortic and iliac disease.
• Treating RAS in these complex patients can be challenging.
• Simultaneous surgical intervention is an option for selected patients.

Purpose of the Study:

• To evaluate the outcomes of simultaneous aortic and renal artery surgery.
• To assess the impact on hypertension and renal function.
• To determine the safety and efficacy of this combined approach.

Main Methods:

• Retrospective review of 63 patients undergoing renal revascularization during aortic surgery.
• Patients had significant RAS with aortoiliac occlusive or aneurysmal disease.
• Analysis of operative mortality, hypertension control, and renal function post-procedure.

Main Results:

• Operative mortality was 3%.
• 60% of hypertensive patients (35/58) were cured or improved.
• Improved renal function was observed in patients with bilateral RAS and moderate azotemia; no patient required dialysis.

Conclusions:

• Simultaneous aortic and renal artery surgery is feasible with low morbidity and mortality.
• The procedure offers significant improvement in hypertension for many patients.
• Renal function and mass preservation can be anticipated in selected cases.