Renal artery revascularization. Restoration of renal function

Fifteen patients with nonfunctioning kidneys and complete main or segmental renal artery occlusion that was discovered on angiographic investigation for hypertension underwent renal artery revascularization. Renal blood flow was restored in all patients. Of these patients, 13 experienced excellent recovery of renal function, one patient had slight return of function, and one patient showed no evidence of improvement. Histologic evidence of intact viable glomeruli, angiographic appearance of collateral circulation, and the presence of proximal occlusion with a patent distal renal artery were necessary for successful results. Revascularization of the ischemic nonfunctioning kidney with restoration of renal function is preferable to nephrectomy when all appropriate criteria are satisfied.