Safety and efficacy of transaortic renal endarterectomy as an adjunct to aortic surgery.

Abstract

PURPOSE:

A study was undertaken to assess the safety and efficacy of transaortic endarterectomy for orificial atherosclerotic renovascular disease (ASRD), particularly in conjunction with surgery for concomitant aortic disease.

METHODS:

Forty-three consecutive patients with ASRD treated with transaortic orificial eversion endarterectomy were studied retrospectively to identify surgical indications, technical features, operative morbidity and mortality rates, and efficacy.

RESULTS:

A total of 76 renal arteries underwent transaortic endarterectomy for hypertension (88% of patients) or serum creatinine of 1.5 mg/dl or greater (65% of patients), including two patients undergoing dialysis. Concomitant aortic surgery was performed in 39 patients for aneurysmal (n = 30) or occlusive (n = 9) disease. Two (2.6%) of 76 renal endarterectomies required intraoperative conversion to bypass because of poor flow, and three arteries (3.9%) were reimplanted or bypassed because of fragility of the renal orifice after endarterectomy. Thirty-day operative death occurred in two patients (4.7%), and major morbidity occurred in six (14.0%). Hypertension was cured or improved in 83% of patients with hypertension. Among patients with preoperative renal insufficiency, function was improved in 19%, with dialysis discontinued in one of two patients receiving dialysis, and function was worse in 23%, with one patient dependent on dialysis.

CONCLUSION:

Transaortic renal endarterectomy is an acceptably safe and effective adjunctive technique in selected patients with combined aortic disease and ASRD.

• Authors: D G Clair, M Belkin, A D Whittemore, J A Mannick, M C Donaldson
• Journal: Journal of vascular surgery (J Vasc Surg) Vol. 21 Issue 6 Pg. 926-33; discussion 934 (Jun 1995) ISSN: 0741-5214 [Print] United States
• PMID: 7776472 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Aorta, Abdominal (surgery)
• Aortic Diseases (complications, surgery)
• Arteriosclerosis (surgery)
• Endarterectomy (methods)
• Female
• Humans
• Intraoperative Complications
• Male
• Middle Aged
• Postoperative Complications (mortality)
• Renal Artery (surgery)
• Renal Artery Obstruction (complications, surgery)
• Retrospective Studies