Combined Renal Artery Stenosis and Aortic Aneurysm: Treatment Options
| Autor: | Robert A. Hieb, John J. Bergan, J. David Killeen, Douglas C. Smith, Jeffrey L. Ballard, T.J. Bunt |
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| Rok vydání: | 1996 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Critical Care medicine.medical_treatment Blood Loss Surgical Endarterectomy Renal Artery Obstruction Renal artery stenosis Preoperative care Aortic aneurysm Renal Artery medicine.artery Angioplasty Preoperative Care Humans Medicine Aorta Abdominal Treatment Failure Renal artery Aged Retrospective Studies business.industry Anastomosis Surgical Age Factors General Medicine Length of Stay medicine.disease Abdominal aortic aneurysm Surgery Hospitalization Stenosis Treatment Outcome Creatinine Replantation Hypertension Female Cardiology and Cardiovascular Medicine business Angioplasty Balloon Aortic Aneurysm Abdominal Follow-Up Studies |
| Zdroj: | Annals of Vascular Surgery. 10:361-364 |
| ISSN: | 0890-5096 |
| DOI: | 10.1007/bf02286780 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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