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Surgical Revascularization

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Book cover Renal Vascular Disease

Abstract

Surgical treatment of renovascular disease changed with the advent of stenting and the introduction of more potent anti-hypertensive medications. Currently, surgical renal revascularization is relegated to patients with recurrent in-stent stenosis, complex fibromuscular disease and renal aneurysms, children and adolescents with renovascular disease, and renal artery bypass or endarterectomy done in conjunction with aortic aneurysm repair or aortofemoral bypass for occlusive disease. Renal artery reconstructions are done with a variety of techniques, and are best done before there is irreversible renal parenchymal damage. Open surgical renal reconstruction has become more complex since the advent of stenting. Careful surgical planning, renal protection, and technical execution of the operation are keys to success.

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References

  1. Bower TC, Duncan AA, Kalra M, Oderich GS, Toomey BJ, Gloviczki P. Current indications and results of surgical reconstructions for renal artery disease at Mayo Clinic. In: Gloviczki P, Shields RC, Bjarnason H, Becquemin JP, Gloviczki P, editors. Mayo Clinic international symposium. Torino: Edizioni Minerva Medica; 2011. p. 190–5.

    Google Scholar 

  2. Edwards MS, Corriere MA. Contemporary management of atherosclerotic renovascular disease. J Vasc Surg. 2009;50:1197–210.

    Article  PubMed  Google Scholar 

  3. White CJ, Olin JW. Diagnosis and management of atherosclerotic renal artery stenosis: improving patient selection and outcomes. Cardiovasc Med. 2009;6:176–90.

    Google Scholar 

  4. Shetty R, Amin MS, Jovin IS. Atherosclerotic renal artery stenosis: current therapy and future developments. Am Heart J. 2009;158:154–62.

    Article  PubMed  Google Scholar 

  5. Textor SC, Glockner JF, Lerman L, Misra S, McKusick MA, Riederer SJ, Grande JP, Gomez S, Romero JC. The use of magnetic resonance to evaluate tissue oxygenation in renal artery stenosis. J Am Soc Nephrol. 2008;19:780–8.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Mozes G, Bower TC, Kalra M, et al. Surgical outcome of renal artery revascularization for atherosclerotic disease. Presented at the Society for Vascular Surgery meeting, Chicago, Illinois, June 2005.

    Google Scholar 

  7. Hallett Jr JW, Textor SC, Kos PB, Nicpon G, Bower TC, Cherry Jr KJ, Gloviczki P, Pairolero PC. Advanced renovascular hypertension and renal insufficiency: trends in medical comorbidity and surgical approach from 1970 to 1993. J Vasc Surg. 1995;21(5):759–60.

    Google Scholar 

  8. Cherr GS, Hansen KJ, Craven TE, Edwards MS, Ligush Jr J, Levy PJ, Freedman BI, Dean RH. Surgical management of atherosclerotic renovascular disease. J Vasc Surg. 2002;35:236–45.

    Article  PubMed  Google Scholar 

  9. Hansen KJ, Cherr GS, Craven TE, Motew SJ, Travis JA, Wond JM, Levy PJ, Freedman BI, Ligush Jr J, Dean RH. Management of ischemic nephropathy: dialysis-free survival after surgical repair. J Vasc Surg. 2000;32:472–82.

    Article  PubMed  CAS  Google Scholar 

  10. Paty PS, Darling SP III C, Lee D, Chang BB, Roddy SP, Kreienberg PG, Lloyd WE, Shah DM. Is prosthetic renal artery reconstruction a durable procedure? An analysis of 489 bypass grafts. J Vasc Surg. 2001;34:127–32.

    Article  PubMed  CAS  Google Scholar 

  11. Marone LK, Clouse WD, Dorer DJ, Brewster DC, LaMuraglia GM, Watkins MT, Kwolek CJ, Cambria RP. Preservation of renal function with surgical revascularization in patients with atherosclerotic renovascular disease. J Vasc Surg. 2004;39:322–9.

    Article  PubMed  Google Scholar 

  12. Uzzo RG, Novick AC, Goormastic M, Mascha E, Pohl M. Medical versus surgical management of atherosclerotic renal artery stenosis. Transplant Proc. 2002;34:723–5.

    Article  PubMed  CAS  Google Scholar 

  13. Balzer K, Pfeiffer T, Rossbach S, Voiculescu A, Modder U, Godehardt E, et al. Operative vs interventional treatment for ostial renal artery occlusive disease (RAOOD): results of a prospective randomized trial. J Vasc Surg. 2009;49:667–74; discussion 674–5.

    Article  PubMed  Google Scholar 

  14. Crutchley TA, Pearce JD, Craven TE, Edwards MS, Dean RH, Hansen KJ. Branch renal artery repair with cold perfusion protection. J Vasc Surg. 2007;46:405–12.

    Article  PubMed  Google Scholar 

  15. Carmo M, Bower TC, Mozes G, Nachreiner RD, Textor SC, Hoskin TL, Kalra M, Noel AA, Panneton JM, Sullivan TM, Gloviczki P. Surgical management of renal fibromuscular dysplasia: challenges in the endovascular era. Ann Vasc Surg. 2005;19:208–17.

    Article  PubMed  Google Scholar 

  16. Stanley JC, Criado E, Upchurch GR, Brophy PD, Cho KJ, Rectenwald JE. Pediatric renovascular hypertension: 132 primary and 30 secondary operations in 97 children. J Vasc Surg. 2006;44:1219–29.

    Article  PubMed  Google Scholar 

  17. Stanley JC, Criado E, Eliason JL, Upchurch Jr GR, Berguer R, Rectenwald JE. Abdominal aortic coarctation: surgical treatment of 53 patients with a thoracoabdominal bypass, patch aortoplasty, or interposition aortoaortic graft. J Vasc Surg. 2008;48:1073–82.

    Article  PubMed  Google Scholar 

  18. Graham LM, Zelenock GB, Erlandson EE, Coran AG, Oindenaur SM, Stanley JC. Abdominal aortic coarctation and segmental hypoplasia. Surgery. 1979;86:519–29.

    PubMed  CAS  Google Scholar 

  19. Upchurch Jr GR, Henke PK, Eagleton MJ, Grigoryants V, Sullivan VV, Wakefield TW, et al. Pediatric splanchnic arterial occlusive disease: clinical relevance operative treatment. J Vasc Surg. 2002;35:860–7.

    Article  PubMed  Google Scholar 

  20. Carr JA. The results of catheter-based therapy, compared with surgical repair of adult aortic coarctation. J Am Coll Cardiol. 2006;47:1101–7.

    Article  PubMed  Google Scholar 

  21. Fields CE, Bower TC, Cooper LT, Hoskin T, Noel AA, Panneton JM, Sullivan TM, Gloviczki P, Cherry Jr KJ. Takayasu’s arteritis: operative results and influence of disease activity. J Vasc Surg. 2006;43(1):64–71.

    Article  PubMed  Google Scholar 

  22. Patel R, Conrad MF, Paruchuri V, Kwolek CJ, Cambria RP. Balloon expandable stents facilitate right renal artery reconstruction during complex open aortic aneurysm repair. J Vasc Surg. 2010;51:310–6.

    Article  PubMed  Google Scholar 

  23. West CA, Noel AA, Bower TC, Cherry Jr KJ, Gloviczki P, Sullivan TM, Kalra M, Hoskin TL, Harrington JR. Factors affecting outcomes of open surgical repair of pararenal aortic aneurysms? A 10-year experience. J Vasc Surg. 2006;43(5):921–7; discussion 927–8.

    Article  PubMed  Google Scholar 

  24. Knott AW, Kalra M, Duncan AA, Reed NR, Bower TC, Hoskin TL, Oderich GS, Gloviczki P. Open repair of juxtarenal aortic aneurysms (JAA) remains a safe option in the era of fenestrated endografts. J Vasc Surg. 2008;47(4):695–701.

    Article  PubMed  Google Scholar 

  25. Quinones-Baldrich W, Jimenez JC, DeRubertis B, Moore W. Combined endovascular and surgical approach (CESA) to thoracoabdominal aortic pathology: a 10-year experience. J Vasc Surg. 2009;49(5):1125–34.

    Article  PubMed  Google Scholar 

  26. Bischoff MS, Di Luozzo G, Griepp EB, Griepp RB. Spinal cord preservation in thoracoabdominal aneurysm repair. Perspect Vasc Surg Endovasc Ther. 2011;23(3):214–22.

    Article  PubMed  Google Scholar 

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Correspondence to Thomas C. Bower MD .

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© 2014 Springer-Verlag London

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Bower, T.C., Oderich, G.S. (2014). Surgical Revascularization. In: Lerman, L., Textor, S. (eds) Renal Vascular Disease. Springer, London. https://doi.org/10.1007/978-1-4471-2810-6_21

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  • DOI: https://doi.org/10.1007/978-1-4471-2810-6_21

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2809-0

  • Online ISBN: 978-1-4471-2810-6

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