[Retrograde repair of complex renal artery stenosis (author's transl)]

Among 60 cases of renal artery repair with venous or arterial autografts, 20 complex lesions involving the bifurcation and the branches of the artery were corrected by retrograde repair. This means that, after excision of the diseased artery, the graft is sutured to the distal branch(es) first, after which the proximal anastomosis is performed. This technique makes easier the distal sutures which are the most difficult, allowing complex repairs and often avoiding extra-corporeal surgery. The total clamping times were 65 to 110 minutes without any protection of the kidney against ischemia. No adverse effect upon renal function ensued these prolonged clamping times.