Concomitant renal revascularization in patients undergoing aortic surgery

Sixty-three patients who underwent renal revascularization at the time of aortic surgery were retrospectively reviewed. These patients had significant renal artery stenosis in addition to either severe aortoiliac occlusive disease or aortic aneurysmal disease. Fifty-eight patients were hypertensive, whereas five patients were normotensive and these renal lesions were treated prophylactically. The operative mortality rate was 3%. Despite lack of selectivity in these patients with diffuse atherosclerosis, 60% (35 of 58) of the patients with hypertension could be classified as either "cured" or "improved." Patients with bilateral renal artery involvement and moderate azotemia were noted to improve with respect to renal function postoperatively. No patient has required chronic dialysis at a mean follow-up period of 22.6 months. Simultaneous aortic and renal artery surgery may be performed with low morbidity and mortality rates and produce a gratifying improvement in hypertension. Renal functional improvement and perhaps preservation of renal mass may be anticipated in selected patients.