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Abstract

Renal revascularization is primarily undertaken to cure or improve renovascular hypertension. A second major objective may be the preservation or restoration of renal function. Although the exact incidence of renovascular hypertension has not been clearly defined, renal artery occlusive disease is commonly regarded as the most important surgically correctable cause of hypertension. The underlying renal artery pathology is usually either atherosclerosis or fibromuscular dysplasia. Rarer causes include Takayasu’s disease or other forms of arteritis, neurofibromatosis, abdominal aortic coarctation, chronic traumatic or embolic lesions and arteriovenous fistulae.

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References

  1. Zinman, L. and Libertino, J. A. (1977). Renovascular hypertension. In Libertino, J. A. and Zinman, L. (eds.) Reconstructive Urologic Surgery. Pediatric and Adult, pp. 56–80. ( Baltimore: Williams and; Wil- kins Co. )

    Google Scholar 

  2. Fry, W. J. (1979). Renal artery reconstruction. Surg. Clin. North Am., 59, 555–563

    PubMed  CAS  Google Scholar 

  3. Kaufman, J. J. (1979). Renovascular hypertension: the UCLA experience. J. Urol., 121, 139–144

    PubMed  CAS  Google Scholar 

  4. Vaughan, E. D., Case, D. B., Pickering, T. G. et al. (1984). Clinical evaluation of renovascular hypertension and therapeutic decisions. Urol. Clin. North Am., 11, 393–407

    PubMed  Google Scholar 

  5. Zabbo, A. and Novick, A. C. (1984). Digital subtraction angiography for noninvasive imaging of the renal artery. Urol. Clin. North. Am., 11, 409–416

    PubMed  CAS  Google Scholar 

  6. Stanley, J. C., Gewertz, B. C., Bove, E. L. ef al. (1975). Arterial fibrodysplasia. Histopathologic character and current etiologic concepts. Arch. Surg., 110, 561–566

    PubMed  CAS  Google Scholar 

  7. Meaney, T. F. and Baghery, S. A. (1982). Radiology of renovascular hypertension. In Breslin, D. J., Swinton, N. W., Libertino J. A. and Zinman, L. (eds.) Renovascular Hypertension, pp. 78–95. ( Baltimore: Williams & Wilkins Co. )

    Google Scholar 

  8. Pickering, T. G., Sos, T. A., Vaughan, E. D. et al. (1984). Predictive value and changes of renin secre¬tion in hypertensive patients with unilateral renovascular disease undergoing successful renal angioplasty. Am. J. Med., 76, 39–04

    Article  Google Scholar 

  9. Marks, L. S. and Maxwell, M. H. (1975). Renal vein renin: value and limitations in the prediction of operative results. Urol. Clin. North Am., 2, 311–325

    PubMed  CAS  Google Scholar 

  10. Rosenthal, J. T., Libertino, J. A., Zinman, L. et al. (1981). Predictability of surgical cure of renovascular hypertension. Ann. Surg., 193, 448–452

    Article  PubMed  CAS  Google Scholar 

  11. Schreiber, M. J., Pohl, M. A. and Novick, A. C. (1984). The natural history of atherosclerotic and fibrous renal artery disease. Urol. Clin. North Am., 11, 383–392

    PubMed  CAS  Google Scholar 

  12. Dean, R. H., Kieffer, R. W., Smith, B. M. etal. (1981). Renovascular hypertension. Anatomic and renal function changes during drug therapy. Arch. Surg., 116, 1408–1415

    PubMed  CAS  Google Scholar 

  13. Dean, R. H., Lawson, J. D., Hollifield, J. W. etal. (1979). Revascularization of the poorly functioning kidney. Surgery, 85, 44–52

    PubMed  CAS  Google Scholar 

  14. Novick, A. C., Pohl, M. A., Schreiber, M. et al. (1983). Revascularization for preservation of renal function in patients with atherosclerotic renovascular disease. J. Urol., 129, 907–912

    PubMed  CAS  Google Scholar 

  15. Lawrie, G. M., Morris, G. C. and DeBakey, M. E (1980). Long-term results of treatment of the totally occluded renal artery in forty patients with renovascular hypertension. Surgery, 88, 753–75

    PubMed  CAS  Google Scholar 

  16. Libertino, J. A., Zinman, L., Breslin, D. J. et al. (1980). Renal artery revascularization. Restoration of renal function. J.A.M.A., 244, 1340–1342

    Article  PubMed  CAS  Google Scholar 

  17. Whitehouse, W. M., Kazmers, A., Zelenock, G. B. et al. (1981). Chronic total renal artery occlusion: Effects of treatment on secondary hypertension and renal function. Surgery, 89, 753–763

    PubMed  Google Scholar 

  18. Stanley, J. C. and Fry, W. J. (1977). Surgical treatment of renovascular hypertension. Arch. Surg., 112, 1291–1297

    PubMed  CAS  Google Scholar 

  19. Starr, D. S., Lawrie, G. M. and Morris, G. C. (1980). Surgical treatment of renovascular hypertension. Long-term follow-up of 216 patients up to 20 years. Arch. Surg., 115, 494–496

    PubMed  CAS  Google Scholar 

  20. Thevenet, A., Mary, H. and Boennec, M. (1980). Results following surgical correction of renovascular hypertension. J. Cardiovasc. Surg., 21, 517–528

    CAS  Google Scholar 

  21. Ernst, C. B., Stanley, J. C., Marshall, F. F. et al. (1973). Renal revascularization for arteriosclerotic renovascular hypertension: prognostic implications of focal renal arterial vs. overt generalized arteriosclerosis. Surgery, 73, 859–867

    PubMed  CAS  Google Scholar 

  22. Novick, A. C., Straffon, R. A., Stewart, B. H. et al. (1981) Diminished operative morbidity and mortality in renal revascularization. J.A.M.A., 246, 749–753

    Article  PubMed  CAS  Google Scholar 

  23. Fry, R. E. and Fry, W. J. (1982). Renovascular hyper-tension in the patient with severe atherosclerosis. Arch. Surg., 117, 938–941

    PubMed  CAS  Google Scholar 

  24. Schwarten, D. E. (1980). Transluminal angioplasty of renal artery stenosis: 70 experiences. A.J.R., 135, 969–974

    CAS  Google Scholar 

  25. Tegtmeyer, C. J., Elson, J., Glass, T. A. etal. (1982). Percutaneous transluminal angioplasty: the treatment of choice for renovascular hypertension due to fibromuscular dysplasia. Radiology, 143, 631–637

    PubMed  CAS  Google Scholar 

  26. Sos, T. A., Pickering, T. G., Sniderman, K. W. etal. (1983). Percutaneous transluminal renal angioplasty in renovascular hypertension due to atheroma or fibromuscular dysplasia. N. Engl. J. Med., 309, 274– 279

    Article  PubMed  CAS  Google Scholar 

  27. Luft, F. C., Grim, C. E. and Weinberger, M. H. (1983). Intervention in patients with renovascular hypertension and renal insufficiency. J. Urol., 130, 654–656

    PubMed  CAS  Google Scholar 

  28. Cicuto, K. P., McLean, G. K., Oleaga, J. A. et al. (1981). Renal artery stenosis: anatomic classification for percutaneous transluminal angioplasty. A.J.R., 137, 599–601

    CAS  Google Scholar 

  29. Sniderman, K. W. and Sos, T. A. (1982). Percutaneous transluminal recanalization and dilatation of totally occluded renal arteries. Radiology, 142, 607–610

    PubMed  CAS  Google Scholar 

  30. Guzzetta, P. C., Potter, B. M., Kapur, S. etal. (1983). Reconstruction of the renal artery after unsuccessful percutaneous transluminal angioplasty in children. Am. J. Surg., 145, 647 - 651

    Article  PubMed  CAS  Google Scholar 

  31. Roizen, M. F., Beaupre, P. N., Alpert, R. A. et al. (1984). Monitoring with two-dimensional transesophageal echocardiography. Comparison of myo-cardial function in patients undergoing supraceliac, suprarenal-infraceliac, or infrarenal aortic occlusion. J. Vase. Surg., 1, 300–305

    CAS  Google Scholar 

  32. Brewster, D. C. (1980). Surgical management of re-novascular disease. A.J.R., 135, 963–967

    CAS  Google Scholar 

  33. Fitzpatrick, J. M. and Wickham, J. E. (1984). Inosine in ischaemic renal surgery. In Wickham, J. E. (ed.). Intra-renal Surgery, pp. 113–128 ( Edinburgh: Churchill Livingstone )

    Google Scholar 

  34. Ekeström, S., Bergdahl, L., Lamke, B. etal. (1984). The advantage of the thoraco-retroperitoneal ap¬proach for aortorenal bypass grafting. J. Cardiovasc. Surg., 25, 427–431

    Google Scholar 

  35. Wylie, E. J. (1981). In Discussion of Hollier, L. H., Bernatz, P. E., Pairolero, P. C. etal. Surgical management of chronic intestinal ischemia: A reappraisal. Surgery, 90, 940–946

    Google Scholar 

  36. Stanley, J. C., Whitehouse, W. M., Zelenock, G. B., et al. (1985). Reoperation for complications of renal artery reconstructive surgery undertaken for treatment of renovascular hypertension. J. Vase. Surg. 2, 133–144

    CAS  Google Scholar 

  37. Stoney, R. J., De Luccia, N., Ehrenfeld, W. K. ei al. (1981). Aortorenal arterial autografts. Long-term assessment. Arch. Surg., 116, 1416–1422

    PubMed  CAS  Google Scholar 

  38. Novick, A. C., Straffon, R. A. and Stewart, B. H. (1980). Surgical management of branch renal artery disease: in situ versus extracorporeal methods of repair. J. Urol., 123, 311–8l1

    PubMed  CAS  Google Scholar 

  39. Novick, A. C., Stewart, B. H. and Straffon, R. A. (1980). Extracorporeal renal surgery and allotransplantation: indications, techniques and results. J. Urol., 123, 806–811

    PubMed  CAS  Google Scholar 

  40. Stoney, R. J., Silane, M. and Salvatierra, O. (1978). Ex vivo renal artery reconstruction. Arch. Surg., 113, 1272–1278

    PubMed  CAS  Google Scholar 

  41. Belzer, F. O. and Raczkowski, A. (1982). Ex vivo renal artery reconstruction with autotransplanta-tion. Surgery, 92, 642–645

    PubMed  CAS  Google Scholar 

  42. Kyriakides, G. K. and Najarían, J. S. (1979). Renovascular hypertension in childhood: successful treatment by renal autotransplantation. Surgery, 85, 611– 616

    PubMed  CAS  Google Scholar 

  43. Dubernard, J. M., Martin, X., Gelet, A. et al. (1985). Renal autotransplantation versus bypass techniques for renovascular hypertension. Surgery, 97, 529–534

    PubMed  CAS  Google Scholar 

  44. Kaufman, J. J. (1973). The middle aortic syndrome: report of a case treated by renal autotransplantation. J. Urol., 109, 711–715

    PubMed  CAS  Google Scholar 

  45. Putnam, C. W., Halgrimson, C. G., Stables, D. P., et al. (1975). Ex vivo renal perfusion and autotransplantation in treatment of calculous disease or abdominal aortic aneurysm. Urology, 5, 337–342

    Article  CAS  Google Scholar 

  46. Novick, A. C., Banowsky, L. H., Stewart, B. H. et al. (1977). Renal revascularization in patients with severe atherosclerosis of the abdominal aorta or a previous operation on the abdominal aorta. Surg. Gynecol. Obstet., 144, 211–218

    PubMed  CAS  Google Scholar 

  47. Adib, K. and Belzer, F. O. (1978). Renal autotrans-plantation in dissecting aortic aneurysm with renal artery involvement. Surgery, 84, 686–688

    PubMed  CAS  Google Scholar 

  48. Chibaro, E. A., Libertino, J. A. and Novick, A. C. (1984). Use of the hepatic circulation for renal reva-scularization. Ann. Surg., 199, 406–411

    Article  PubMed  CAS  Google Scholar 

  49. Ricotta, J. J. and Williams, G. M. (1980). Endarterec- tomy of the upper abdominal aorta and visceral arteries through an extraperitoneal approach. Ann. Surg., 192, 633–638

    PubMed  CAS  Google Scholar 

  50. Perry, M. O. and Silane, M. F. (1984). Management of renovascular problems during aortic operations. Arch. Surg., 119, 681–685

    PubMed  CAS  Google Scholar 

  51. Stoney, R. J., Skioldebrand, C. G., Qvarfordt, P. G. et al. (1984). Juxtarenal aortic atherosclerosis. Surgical experience and functional result. Ann. Surg., 200, 345–354

    Article  PubMed  CAS  Google Scholar 

  52. Dean, R. H., Keyser, J. E., Dupont, W. D. et al. (1984). Aortic and renal vascular disease. Factors affecting the value of combined procedures. Ann. Surg., 200, 336–344

    Article  PubMed  CAS  Google Scholar 

  53. DeBakey, M. E., Garrett, H. E., Howell, J. F. et al. (1967). Coarctation of the abdominal aorta with renal arterial stenosis: surgical considerations. Ann. Surg., 165, 830–643

    Article  PubMed  Google Scholar 

  54. Graham, L. M., Zelenock, G. B., Erlandson, E. E. et al. (1979). Abdominal aortic coarctation and seg¬mental hypoplasia. Surgery, 86, 519–529

    PubMed  CAS  Google Scholar 

  55. Lande, A. (1976). Takayasu’s arteritis and congenital coarctation of the descending thoracic and abdominal aorta: a critical review, A.J.R., 127, 227–233

    CAS  Google Scholar 

  56. Stanley, J. C., Graham, L. M., Whitehouse, W. M. et al. (1981). Developmental occlusive disease of the abdominal aorta and the splanchnic and renal arteries. Am. J. Surg., 142, 190–196

    Article  PubMed  CAS  Google Scholar 

  57. Stanley, J. C., Rhodes, E. L., Gewertz, B. L. et al. (1975). Renal artery aneurysms. Significance of ma- croaneurysms exclusive of dissections and fibrody- splastic mural dilations. Arch. Surg., 110, 1327–1333

    PubMed  CAS  Google Scholar 

  58. Zinman, L. and Libertino, J. A. (1982). Uncommon disorders of the renal circulation. In Breslin, D. J., Swinton, N. W., Libertino, J. A. and Zinman, L. (eds.) Renovascular Hypertension, pp. 106–122. ( Baltimore: Williams and Wilkins Co. )

    Google Scholar 

  59. Youkey, J. R., Collins, G. J., Orecchia, P. M. et al. (1985)Saccular renal artery aneurysm as a cause of hypertension. Surgery, 97, 498–501

    PubMed  CAS  Google Scholar 

  60. Tham, G., Ekelund, L., Herrlin, K. etal. (1983). Renal artery aneurysms. Natural history and prognosis. Ann. Surg., 197, 348–352

    Article  PubMed  CAS  Google Scholar 

  61. Poutasse, E. F. (1975). Renal artery aneurysms. J. Urol., 113, 443–449

    PubMed  CAS  Google Scholar 

  62. Love, W. K., Robinette, M. A. and Vernon, C. P. (1981). Renal artery aneurysm rupture in pregnancy. J. Urol., 126, 809–811

    PubMed  CAS  Google Scholar 

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Ward, A.S., Cormier, J.M. (1986). Surgery of the Renal Arteries. In: Operative Techniques in Arterial Surgery. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-4129-8_13

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  • DOI: https://doi.org/10.1007/978-94-009-4129-8_13

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-8331-7

  • Online ISBN: 978-94-009-4129-8

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