Abstract
Ex vivo renal artery reconstruction and autotransplantation is a relatively recent addition to the surgical armamentarium for renal vascular hypertension. Ten consecutive patients were considered for this surgical therapy and form the basis of this communication. The patients were treated by a combination of methods including bilateral ex vivo reconstruction, unilateral in situ and contralateral ex vivo reconstruction, and unilateral ex vivo reconstruction and contralateral nephrectomy. Replacement of the diseased segment of the renal artery in all ex vivo reconstruction consisted of arterial autografts including hypogastric artery, splenic artery, common iliac, and external iliac artery. In the ex vivo reconstruction, the ureter was either left intact or was transected and reconstructed by standard ureterovesicle implantation. After surgery all patients became normotensive without antihypertensive medication. Although this is a relatively small series, the uniform good results in these patients with extensive disease suggest that ex vivo renal artery reconstruction is a safe and effective method of treatment. Thus, it should be more widely applicable, expecially in those patients with renal vascular disease who were previously thought to be inoperable or eligible for nephrectomy only.
Full text
PDF






Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Belzer F. O., Keaveny T. V., Reed T. W., Pryor J. P. A new method of renal artery reconstruction. Surgery. 1970 Oct;68(4):619–624. [PubMed] [Google Scholar]
- Belzer F. O., Salvatierra O., Perloff D., Grausz H. Surgical correction of advanced fibromuscular dysplasia of the renal arteries. Surgery. 1974 Jan;75(1):31–37. [PubMed] [Google Scholar]
- Clunie G. J., Murphy K. J., Nicoll P., Lukin L., Marsden R. T. Autotransplantation of the kidney in the treatment of renovascular hypertension. Surgery. 1971 Mar;69(3):326–331. [PubMed] [Google Scholar]
- Corman J. L., Anderson J. T., Taubman J., Stables D. P., Halgrimson C. G., Popovtzer M., Starzl T. E. Ex vivo perfusion, arteriography, and autotransplantation procedures for kidney salvage. Surg Gynecol Obstet. 1973 Oct;137(4):659–665. [PMC free article] [PubMed] [Google Scholar]
- Dean R. H., Wilson J. P., Burko H., Foster J. H. Saphenous vein aortorenal bypass grafts: Serial arteriographic study. Ann Surg. 1974 Oct;180(4):469–478. doi: 10.1097/00000658-197410000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fry W. J., Brink B. E., Thompson N. W. New techniques in the treatment of extensive fibromuscular disease involving the renal arteries. Surgery. 1970 Dec;68(6):959–967. [PubMed] [Google Scholar]
- Guerriero W. G., Scott R., Jr, Joyce L. Development of extracorporeal renal perfusion as an adjunct for bench renal surgery. J Urol. 1972 Jan;107(1):4–8. doi: 10.1016/s0022-5347(17)60930-3. [DOI] [PubMed] [Google Scholar]
- Hoffmann R. M., Stieper K. W., Johnson R. W., Belzer F. O. Renal ischemic tolerance. Arch Surg. 1974 Oct;109(4):550–551. doi: 10.1001/archsurg.1974.01360040068017. [DOI] [PubMed] [Google Scholar]
- Lawson R. K., Hodges C. V., Pitre T. M. Nephrectomy, microvascular repair, and autotransplantation. Surg Forum. 1972;23(0):539–541. [PubMed] [Google Scholar]
- Lim R. C., Jr, Eastman A. B., Blaisdell F. W. Renal autotransplantation. Adjunct to repair of renal vascular lesions. Arch Surg. 1972 Dec;105(6):847–852. doi: 10.1001/archsurg.1972.04180120028007. [DOI] [PubMed] [Google Scholar]
- Najarian J. S., Gulyassy P. P., Stoney R. J., Duffy G., Braunstein P. Protection of the donor kidney during homotransplantation. Ann Surg. 1966 Sep;164(3):398–417. doi: 10.1097/00000658-196609000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ota K., Mori S., Awane Y., Ueno A. Ex situ repair of renal artery for renovascular hypertension. Arch Surg. 1967 Mar;94(3):370–373. doi: 10.1001/archsurg.1967.01330090064016. [DOI] [PubMed] [Google Scholar]
- Salvatierra O., Jr, Kountz S. L., Belzer F. O. Prevention of ureteral fistula after renal transplantation. J Urol. 1974 Oct;112(4):445–448. doi: 10.1016/s0022-5347(17)59757-8. [DOI] [PubMed] [Google Scholar]
- Stanley J. C., Ernst C. B., Fry W. J. Fate of 100 aortorenal vein grafts: characteristics of late graft expansion, aneurysmal dilatation, and stenosis. Surgery. 1973 Dec;74(6):931–944. [PubMed] [Google Scholar]









