Objective: Diagnosis and management of renovascular diseases (RVD) at Hokkaido University Hospital was reviewed with particular emphasis on surgical revascularization (SR). Patients and Methods: We studied a total of 33 patients with RVD [16 patients with renal artery stenosis (RAS): group 1, and 17 patients with renal artery aneurysm (RAA): group 2, 10 males, 23 females, aged 9–69 years (median 46), unilateral 24, bilateral 9]. Functional diagnosis of RVD with regard to renovascular hypertension (RVH) was done with the captopril test (CP-T) and captopril-enhanced 99mTc-DTPA (diethylenetriamine-pentaacetic acid) renal scintigraphy (CER). All were subjected to SR. Number, length, size and site of RVD with involvement of branch arteries dictated the choice of operative method but basically in situ repair for main trunk disease (11 kidneys) and ex vivo bench repair with autotransplantation for those beyond the first bifurcation intrarenally involving branched arteries (24 kidneys) were employed. The outcome was analyzed as to blood pressure control, split renal function, and branch renal artery patency. Results: (1) Sensitivity of CP-T and CER was 79 and 77% respectively in group 1, while it was 40 and 38% respectively in group 2. (2) Blood pressure was cured in 66.7% (group 1, 68.8% and group 2, 63.6%) and improved in 22.2% (group 1, 18.8% and group 2, 27.3%) with an overall success rate of 88.9%. (3) Renal function was good in 81.3% (group 1, 83.3% and group 2, 78.6%) and fair in 9.4% (group 1, 0% and group 2, 21.4%) with overall success in 90.7%. (4) Patency was preserved in 90.5% of branch anastomoses. Conclusions: Despite challenging complexities, SR of RVD is feasible with a reasonable amount of morbidity and effective in controlling blood pressure and preserving renal function in the majority of cases.

Keywords:
Renal artery stenosis, Renal artery aneurysm, Surgical revascularization
This content is only available via PDF.
© 2002 S. Karger AG, Basel
2002
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.