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Long-term effectiveness of extraanatomic renal artery revascularization
J M Reilly1, B G Rubin, R W Thompson
1Department of Surgery, Washington University School of Medicine, St. Louis, Mo.
Surgery
|October 1, 1994
Summary
Extraanatomic renal bypass is effective for treating hypertension and preserving kidney function, offering a safe alternative to direct aortorenal bypass. This procedure shows good outcomes in patients with significant risk factors.
Area of Science:
- Vascular Surgery
- Nephrology
- Cardiovascular Medicine
Background:
- Direct aortorenal bypass and renal artery endarterectomy are established renal revascularization techniques.
- Extraanatomic renal revascularization outcomes require further definition.
- This study focuses on the results of extraanatomic renal revascularization procedures.
Purpose of the Study:
- To better define the outcomes of extraanatomic renal revascularization.
- To assess the efficacy of extraanatomic bypass in treating hypertension and preserving renal function.
- To evaluate the morbidity and mortality associated with these procedures.
Main Methods:
- A retrospective review of 124 renal artery revascularization patients from April 1987 to March 1993.
- Analysis of 49 extraanatomic renal artery bypasses performed in 48 patients (average age 65.9 years).
- Detailed recording of preoperative risk factors, creatinine levels, antihypertensive medications, and types of bypass procedures performed.
Main Results:
- No deaths occurred among the 48 patients undergoing extraanatomic bypass.
- Hypertension improved or was cured in 85% of patients post-procedure.
- Postoperative average creatinine levels decreased from 2.3 to 1.7 mg/dl, and medication use reduced.
Conclusions:
- Extraanatomic bypass is an efficacious treatment for hypertension and renal function preservation.
- The procedure demonstrates an acceptable rate of morbidity and mortality.
- Extraanatomic renal revascularization is a viable alternative to direct aortorenal artery bypass.