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Ex vivo renal artery reconstruction
Archives of Surgery (Chicago, Ill. : 1960)
|November 1, 1978
Summary
This study demonstrates successful renal artery reconstruction using hypogastric artery autografts, avoiding kidney damage and improving hypertension in 95% of patients. The technique offers a viable alternative to nephrectomy for extensive renal vascular lesions.
Area of Science:
- Vascular Surgery
- Nephrology
- Cardiovascular Research
Background:
- Extensive renal artery lesions often necessitate nephrectomy, leading to loss of kidney function.
- Developing effective surgical techniques for renal artery reconstruction is crucial for preserving renal viability.
- Continuous hypothermic perfusion and autograft replacement offer a potential solution for complex cases.
Observation:
- Twenty-four patients with 26 extensive renal artery lesions underwent ex vivo reconstruction.
- A hypogastric artery autograft was used to replace the diseased segment of the renal artery.
- Continuous hypothermic perfusion was maintained during the procedure.
Findings:
- Postoperative acute tubular necrosis was successfully avoided in all repaired kidneys.
- One case of graft occlusion resulted in the sole failure, with a 95% success rate in improving or curing hypertension.
- Long-term follow-up (up to six years) showed no degradation of the autografts on arteriograms.
Implications:
- This reconstructive approach significantly expands the applicability of renal artery repair beyond traditional indications.
- It presents a valuable alternative to nephrectomy, preserving kidney function for a wider range of vascular pathologies.
- The technique holds promise for improving outcomes in patients with complex renal artery disease and associated hypertension.