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Aorto-Iliac Occlusive Disease: Extension Cephalad to Origin of Renal Arteries, With Surgical Considerations and Results

Aorto-Iliac Occlusive Disease: Extension Cephalad to Origin of Renal Arteries, With Surgical... Abstract Seventy-one patients with aorto-iliac occlusive disease and associated renalartery stenosis were operated on at the Mayo Clinic. Of these, 65% (46) had hypertension and 18% (13) had chronic renal failure. Revascularization of the lower extremities was performed with bifurcated, knitted Dacron prostheses in all cases. Endarterectomy of the origin of the renal arteries, from inside the aorta, was the most frequent method used to revascularize the kidneys (49 cases). The operative mortality was 6% (four patients). After a mean follow-up of three years, 81% (58) of the patients had significant benefit from revascularization of the lower extremities, and 46% (33) of the hypertensive patients had normal blood pressure. Eight other patients were normotensive when taking a diuretic. The most significant postoperative complication was renal failure, which occurred in 12 cases; it was transitory in six of these. References 1. Gomes MR, Bernatz PE, Juergens JL: Aortoiliac surgery: Influence of clinical factors on results . Arch Surg 95:387-393, 1967.Crossref 2. Hunt JC, Bernatz PE, Harrison EG Jr: Factors determining diagnosis and choice of treatment of renovascular hypertension: Influence of location, severity, and type of stenosing lesions . Circ Res 21 ( (suppl 2) ):211-223, 1967. 3. Brest AN, Cangiano JL, Moyer JH: Laboratory diagnosis of renal arterial hypertension , in Brest AN, Moyer JH (eds): Atherosclerotic Vascular Disease . New York, Appleton-Century-Crofts, 1967, pp 389-397. 4. Onesti G: Effect of renal artery occlusive disease on renal function , in Brest AN, Moyer JH (eds): Atherosclerotic Vascular Disease . New York, Appleton-Century-Crofts, 1967, pp 398-403. 5. Holley KE, Hunt JC, Brown AL Jr, et al: Renal artery stenosis: A clinical-pathologic study in normotensive and hypertensive patients . Amer J Med 37:14-22, 1964.Crossref 6. Van Velzer DA, Burge CH, Morris GC Jr: Arteriosclerotic narrowing of renal arteries associated with hypertension . Amer J Roentgen 86:807-818, 1961. 7. Sheps SG, Wollenweber J, Davis GD: Clinical aspects of the natural history of atherosclerotic renovascular disease , in Brest AN, Moyer JH (eds): Atherosclerotic Vascular Disease . New York, Appleton-Century-Crofts, 1967, pp 374-388. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Aorto-Iliac Occlusive Disease: Extension Cephalad to Origin of Renal Arteries, With Surgical Considerations and Results

Gomes, Manuel M. R.; Bernatz, Philip E.
Archives of Surgery , Volume 101 (2) – Aug 1, 1970
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References (6)

Publisher
American Medical Association
Copyright
Copyright © 1970 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1970.01340260065011
Publisher site
See Article on Publisher Site

Abstract

Abstract Seventy-one patients with aorto-iliac occlusive disease and associated renalartery stenosis were operated on at the Mayo Clinic. Of these, 65% (46) had hypertension and 18% (13) had chronic renal failure. Revascularization of the lower extremities was performed with bifurcated, knitted Dacron prostheses in all cases. Endarterectomy of the origin of the renal arteries, from inside the aorta, was the most frequent method used to revascularize the kidneys (49 cases). The operative mortality was 6% (four patients). After a mean follow-up of three years, 81% (58) of the patients had significant benefit from revascularization of the lower extremities, and 46% (33) of the hypertensive patients had normal blood pressure. Eight other patients were normotensive when taking a diuretic. The most significant postoperative complication was renal failure, which occurred in 12 cases; it was transitory in six of these. References 1. Gomes MR, Bernatz PE, Juergens JL: Aortoiliac surgery: Influence of clinical factors on results . Arch Surg 95:387-393, 1967.Crossref 2. Hunt JC, Bernatz PE, Harrison EG Jr: Factors determining diagnosis and choice of treatment of renovascular hypertension: Influence of location, severity, and type of stenosing lesions . Circ Res 21 ( (suppl 2) ):211-223, 1967. 3. Brest AN, Cangiano JL, Moyer JH: Laboratory diagnosis of renal arterial hypertension , in Brest AN, Moyer JH (eds): Atherosclerotic Vascular Disease . New York, Appleton-Century-Crofts, 1967, pp 389-397. 4. Onesti G: Effect of renal artery occlusive disease on renal function , in Brest AN, Moyer JH (eds): Atherosclerotic Vascular Disease . New York, Appleton-Century-Crofts, 1967, pp 398-403. 5. Holley KE, Hunt JC, Brown AL Jr, et al: Renal artery stenosis: A clinical-pathologic study in normotensive and hypertensive patients . Amer J Med 37:14-22, 1964.Crossref 6. Van Velzer DA, Burge CH, Morris GC Jr: Arteriosclerotic narrowing of renal arteries associated with hypertension . Amer J Roentgen 86:807-818, 1961. 7. Sheps SG, Wollenweber J, Davis GD: Clinical aspects of the natural history of atherosclerotic renovascular disease , in Brest AN, Moyer JH (eds): Atherosclerotic Vascular Disease . New York, Appleton-Century-Crofts, 1967, pp 374-388.

Journal

Archives of Surgery – American Medical Association

Published: Aug 1, 1970

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