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A Vascular Reconstructive Approach

Michael E. De Bakey, MD; Edward A. Lefrak, MD; Raul Garcia-Rinaldi, MD; George P. Noon, MD

AMA Arch Surg. 1973;106(4):438-443.

Abstract
Twenty-one patients were shown roentgenographically to have one or more renal artery aneurysm. Twelve patients had concomitant renal arterial stenosis. Other than aortography and selective renal angiography, ring-shaped calcification on the abdominal roentgenogram was the only helpful guideline to proper diagnosis.

Ninety percent of the patients were hypertensive despite treatment with specific antihypertensive medications. The average preoperative blood pressure was 184/118 mm Hg. A selection of angioplastic and bypass techniques allowed resection of renal artery aneurysms and preservation of the intact kidneys in 19 of 21 patients. Arterial pressure was reduced to an average of 142/85 mm Hg at the time of discharge from the hospital and to 150/87 mm Hg, 1 to 11 years after surgery.

Nephrectomy is rarely indicated as the primary operation for aneurysms of the renal artery since direct vascular reconstruction can be successfully performed in most of these patients.

Author Affiliations
Houston

From the Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston.

Footnotes
Received for publication Nov 21, 1972; accepted Dec 15.

Read before the 80th annual meeting of the Western Surgical Association, Rochester, Minn, Nov 16, 1972.

Reprint requests to Baylor College of Medicine, Department of Surgery, 1200 Moursund Ave, Houston 77025 (Dr. Lefrak).

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