Summary
As newer surgical techniques and concepts have emerged, including revascularization of the totally occluded renal artery and alternatives to aortorenal bypass (hepatic, splenic, or iliac artery to renal artery grafts), our patient population has changed dramatically. Patients with diffuse atherosclerotic disease, bilateral renal artery stenosis, totally occluded renal arteries, and azotemia are more commonly referred for renal revascularization, thereby changing the indications for operation and the results that can be anticipated. Although our results in patients undergoing surgery solely for uncontrollable hypertension or renal failure have been successful, much work needs to be done to improve the results obtained in patients with a combination of uncontrollable hypertension and renal failure.
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References
Foster JH, Maxwell MH, Franklin SS et al. (1975) Renovascular occlusive disease: results of operative treatment. JAMA 231:1043–1048
Freeman NE, Leeds FH, Elliott WG (1954) Thromboendarterectomy for hypertension due to renal artery occlusion. JAMA 156:1077–1078
Fry WJ, Brink BE, Thompson NW (1970) New techniques in the treatment of extensive fibromuscular disease involving the renal arteries. Surgery 68:959–967
Harrison EG Jr, McCormack LJ (1971) Pathologic classification of renal artery disease in renovascular hypertension. Mayo Clin Proc 46:161–167
Hunt JC, Sheps SG, Harrison EG Jr (1974) Renal and renovascular hypertension: a reasoned approach to diagnosis and management. Arch Intern Med 133:988–999
Kaufman JJ, Maxwell MH (1964) Surgery for renovascular hypertension: analysis of 67 cases. JAMA 190:709–714
Libertino JA, Selman FJ Jr (1982) Alternatives to aortorenal revascularization. J Cardiovasc Surg 23:318–322
Libertino JA, Zinman L (1982) Surgery for renovascular hypertension. In: Breslin DJ, Swinton NW Jr, Libertino JA, Zinman L (eds) Renovascular hypertension. Williams & Wilkins, Baltimore, pp 166–212
Libertino JA, Zinman L (1987) Surgery for renovascular hypertension. In: Libertino JA (ed) Pediatric and adult reconstructive urologic surgery, 2nd edn. Williams & Wilkins, Baltimore, pp 119–161
Libertino JA, Zinman L, Breslin DJ (1976) Hepatorenal artery bypass in management of renovascular hypertension. J Urol 115:369–372
Libertino JA, Flam TA, Zinman L, Ying CY, Breslin DJ, Swinton NW Jr, Phelps MD, Bapatsaris NP, Woods BO (1988) Changing concepts in surgical management of renovascular hypertension. Arch Intern Med 148:357–359
Morris GC Jr, DeBakey ME, Cooley DA, et al. (1953) Experience with 200 renal artery reconstructive procedures for hypertension or renal failure. Circulation 27:346–350
Ota K, Mori S, Awane Y et al. (1967) Ex situ repair of renal artery for renovascular hypertension. Arch Surg 94:370–373
Schefft P, Novick AC, Stewart BH (1980) Renal revascularization in patients with total occlusion of the renal artery. J Urol 124:184–186
Straffon R, Siegel DF et al. (1975) Saphenous vein bypass graft in the treatment of renovascular hypertension. Urol Clin North Am 2:337–350
Ying CY, Tifft CP, Gavras H et al. (1984) Renal revascularization in azotemic hypertensive patients resistant to therapy. N Engl J Med 311:1070–1075
Zinman L, Libertino JA (1973) Revascularization of the totally occluded renal artery (abstract). Circulation 48 [Suppl 4]:31
Zinman L, Libertino JA (1977) Revascularization of the chronic totally occluded renal artery with restoration of renal function. J Urol 118:517–521
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Libertino, J. Changing concepts in the surgical management of renovascular hypertension. World J Urol 7, 91–97 (1989). https://doi.org/10.1007/BF01576892
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DOI: https://doi.org/10.1007/BF01576892