Faculty Collaboration Database

Combined renal artery stenosis and aortic aneurysm: treatment options. Ann Vasc Surg 1996 Jul;10(4):361-4

Date

07/01/1996

Pubmed ID

8879391

DOI

10.1007/BF02286780

Scopus ID

2-s2.0-0030179134 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

The purpose of this study was to analyze outcomes of two different treatment strategies in patients treated for renal artery (RA) stenosis and a coincidental abdominal aortic aneurysm (AAA). A total of 50 patients were encountered who required treatment for concomitant RA stenosis and an AAA from 1980 to 1994. Simultaneous operative aortic and RA reconstruction was done in 32 patients, whereas 18 patients where treated with preoperative percutaneous transluminal renal artery angioplasty (PTRA). The two groups were well matched with respect to age, AAA size, incidence of hypertension, preoperative creatinine level, and creatinine clearance (all p values > 0.07). Aortorenal bypass (18 RAs), reimplantation (18 RAs), or endarterectomy (2 RAs) was performed to correct a mean RA stenosis of 88%, whereas 23 RAs (91% mean stenosis) were treated with preoperative PTRA. PTRA failed in four patients with RA stenosis, and they were successfully treated with surgery (3 bypasses and 1 reimplantation). Statistical analysis did not demonstrate a significant difference between these four failed PTRA patients, the 14 successful PTRA patients, and the 32 RA reconstruction patients in terms of operating time (p = 0.15), operative blood loss (p = 0.20), intensive care unit days (p = 0.71), or total hospital days (p = 0.94). Among the 40 patients available for follow-up, hypertension was cured in seven, improved in 10, unchanged in 15, and worse in eight with no difference demonstrated between the groups (p = 0.73). These data suggest that preoperative PTRA has no specific advantage over surgical RA reconstruction in patients with concomitant RA stenosis and AAA. Failed PTRA did not preclude or complicate subsequent operative RA revascularization.

Author List

Ballard JL, Hieb RA, Smith DC, Bergan JJ, Bunt TJ, Killeen JD

Author

Robert A. Hieb MD, RVT, FSIR Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Age Factors
Aged
Anastomosis, Surgical
Angioplasty, Balloon
Aorta, Abdominal
Aortic Aneurysm, Abdominal
Blood Loss, Surgical
Creatinine
Critical Care
Endarterectomy
Female
Follow-Up Studies
Hospitalization
Humans
Hypertension
Length of Stay
Male
Preoperative Care
Renal Artery
Renal Artery Obstruction
Replantation
Retrospective Studies
Time Factors
Treatment Failure
Treatment Outcome