Results of combined reconstructions of the renal arteries, abdominal aorta and its other branches in patients with atherosclerosis

• Published in: Vestnik hirurgii im. I.I. Grekova Vol. 171; no. 3; pp. 16 - 19
• Main Authors: Semenov, D V, Ignashov, A M, Turobova, E P, Martynenko, G I, Vakhitov, K M
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2012
• Subjects: Aorta, Abdominal - physiopathology; Aorta, Abdominal - surgery; Atherosclerosis - complications; Atherosclerosis - physiopathology; Blood Pressure Determination; Comparative Effectiveness Research; Endarterectomy - adverse effects; Endarterectomy - methods; Female; Humans; Hypertension, Renovascular - diagnosis; Hypertension, Renovascular - etiology; Kidney Function Tests; Lower Extremity - blood supply; Male; Middle Aged; Monitoring, Physiologic - methods; Regional Blood Flow; Renal Artery - physiopathology; Renal Artery - surgery; Renal Artery Obstruction - etiology; Renal Artery Obstruction - physiopathology; Renal Artery Obstruction - surgery; Renal Insufficiency - diagnosis; Renal Insufficiency - etiology; Severity of Illness Index; Survival Analysis; Treatment Outcome
• ISSN: 0042-4625

A comparative analysis was made of clinical indices and long-term survival in 20 patients (13 men and 7 women of mean age 62 +/- 2 years), having multifocal atherosclerosis of the renal arteries (RA), abdominal aorta and arteries of lower extremities (LE) (11 aneurysms, 7 occlusive lesions of the aorta and 3 of its unpaired branches) who underwent combined reconstructions, with patients having similar lesions, but not operated (12) or operated only on RA or on the arteries of LE (45). The groups of patients had no great differences except more pronounced renal dysfunction (RD) in the first of them. In spite of high postoperative lethality (20%) mainly due to acute renal failure (3), long-term survival proved to be significantly higher (14 from 16), than in not operated (3 from 12) (p = 0.00001) and had better tendency than in those operated on the same basin (35 from 45). In addition, the patients after combined operations had substantially decreased systolic and diastolic arterial pressure (159 +/- 13 vs. 132 +/- 9, p = 0.00001; 91 +/- 5 vs. 83 +/- 7, p = 0.010) and also stabilized renal function.