Sage Journals: Discover world-class research

Abstract

This report reviews renovascular disease, hypertension and renal parenchymal dysfunction. The primary lesions responsible are discussed as well as the strategies for restoring normal renal perfusion. The natural history studies document progressive impairment of renal perfusion and the consequence of renal dysfunction. Renal revascularization interrupts this pathway by relieving or lessening hypertension and preserving renal function which are the therapeutic options.

Keywords

renovascular disease revascularization angioplasty renal endarterectomy reconstruction

Get full access to this article

View all access options for this article.

References

Goldblatt

Lynch

Hanzal

Summerville

. Studies on experimental hypertension. I. The production of persistent elevation of systolic blood pressure by means of renal ischemia. J Exp Med 1934; 59: 347–9.

Bech

Hilden

. The frequency of secondary hypertension. Acta Med Scand 1975; 197: 65–9.

Kautmann

. Renovascular hypertension: The UCLA experience. J Urol 1979; 121: 139–44.

Dean

. Renovascular hypertension. In: Moore

, ed. Vascular Surgery. A Comprehensive Review. Philadelphia, Pennsylvania: WB Saunders, 1991: 406.

Eyler

Clark

Carman

Rian

Meininger

. Angiography of the renal areas including a comparative study of renal arterial stenoses in patients with and without hypertension. Radiology 1962; 78: 879–92.

Holley

Hunt

Brown

Kincaid

Sheps

. Renal artery stenosis. A clinical-pathological study in normotensive and hypertensive patients. Am J Med 1964; 37: 14–22.

Olin

Melia

Young

Graor

Risius

. Prevalence of atherosclerotic renal artery stenosis in patients with atherosclerosis elsewhere. Am J Med 1990; 88: N46–51.

Choudri

Cleland

JGF

Rowlands

Tran

McCarty

Al-Kutoubi

MAO

. Unsuspected renal artery stenosis in peripheral vascular disease. B M J 1990; 301: 1197–8.

Meaney

Dustan

McCormack

. Natural history of renal arterial disease. Radiology 1968; 91: 881–7.

10.

Wollenweber

Sheps

Davis

. Clinical course of atherosclerotic renovascular disease. Am J Cardiol 1968; 21; 60–3.

11.

Dean

Kieffer

Smith

Renovascular hypertension. Anatomic and renal function changes during drug therapy. Arch Surg 1981; 116: 1408–15.

12.

Schreiber

Pohl

Novick

. The natural history of atherosclerotic and fibrous renal artery disease. Urol Clin North Am 1984; 11: 383–92.

13.

Tollefson

DFJ

Ernst

. Natural history of atherosclerotic renal artery stenosis associated with aortic disease. J Vasc Surg 1991; 14: 327–31.

14.

Zierler

Bergelin

Isaacson

Strandness

. Natural history of atherosclerotic renal artery stenosis: A prospective study with duplex ultrasonography. J Vasc Surg 1994; 19: 250–8.

15.

Cicuto

McLean

Oleaga

Frieman

Grossman

Ring

. Renal artery stenosis: Anatomic classification for percutaneous transluminal angioplasty. AJR American Journal of Roentgenology 1981: 137: 599–601.

16.

Sos

Pickering

Sniderman

Percutaneous transluminal renal angioplasty in renovascular hypertension due to atheroma or fibromuscular dysplasia. N Engl J Med 1983; 309: 274–9.

17.

Hayes

Risius

Novick

Experience with percutaneous transluminal angioplasty for renal artery stenosis at the Cleveland Clinic. J Urol 1988; 139: 488–92.

18.

Canzanello

Millan

Spiegel

Ponce

Kopelman

Madias

. Percutaneous transluminal renal angioplasty in management of atherosclerotic renovascular hypertension: Results in 100 patients. Hypertension 1989; 13: 163–72.

19.

Sos

. Angioplasty for the treatment of azotemia and renovascular hypertension in atherosclerotic renal artery disease. Ciculation 1991; 83: (Suppl. 1): 162–6.

20.

Bredenberg

Sampson

Ray

Cormier

Heintz

Eldrup-Jorgensen

. Changing patterns in surgery for chronic renal artery occlusive diseases. J Vasc Surg 1992; 15: 1018–24.

21.

Hallet

Fowl

O'Brien

Renovascular operations in patients with chronic renal insufficiency: do the benefits justify the risks? J Vasc Surg 1987; 5: 622–7.

22.

Libertino

Bosco

Ying

Renal revascularization to preserve and restore renal function. J Urol 1992; 147: 1485–7.

23.

Hansen

Starr

Sands

Burkart

Plonk

Dean

. Contemporary surgical management of renovascular disease. J Vasc Surg 1992; 16: 319–31.

24.

Lawrie

Morris

Glaeser

DeBakey

. Renovascular reconstruction: Factors affecting long-term prognosis in 919 patients followed up to 31 years. Am J Cardiol 1989; 63: 1085–92.

25.

Novick

Ziegelbaum

Vidt

Gifford

Pohl

Goormastic

Trends in surgical revascularization for renal artery disease. Ten years' experience. JAMA 1987; 257: 498–501.

26.

van Bockel

van Schilfgaarde

Felthius

Hermans

van Brummelen

Terpstra

. Surgical treatment of renovascular hypertension caused by arteriosclerosis. I. Influence of preoperative factors on blood pressure control early and late after reconstructive surgery. Surgery 1987; 101: 698–705.

27.

Dean

Englund

Dupont

Retrieval of renal function by revascularization. Study of preoperative outcome predictors. Ann Surg 1985; 202: 367–75.

28.

Dean

Lawson

Hollifield

Shack

Polterauer

Rhamy

. Revascularization of the poorly functioning kidney. Surgery 1979; 85: 44–52.

29.

Libertino

Flam

Zinman

Changing concepts in surgical management of renovascular hypertension. Arch Intern Med 1988; 148: 357–9.

30.

Novick

Pohl

Schreiber

Gifford

Vidt

. Revascularization for preservation of renal function in patients with atherosclerotic renovascular disease. J Urol 1983; 129: 907–12.

31.

Wylie

Perloff

Stoney

. Autogenous tissue revascularization techniques in surgery for renovascular hypertension. Ann Surg 1969; 170: 416–28.

32.

Stoney

Messina

Goldstone

Reilly

. Renal endarterectomy through the transected aorta: A new technique for combined aortorenal atherosclerosis — A preliminary report. J Vasc Surg 1989; 9: 224–33.

33.

Sauer

Stoney

. Transabdominal exposure of the pararenal aorta and medial visceral rotation. Semin Vasc Sure 1989; 2: 209–13.

34.

Wylie

. Vascular replacement with arterial autografts. Surgery 1964; 57: 14–21.

35.

Stoney

DeLuccia

Ehrenfeld

Wylie

. Aortorenal arterial autografts: Long-term assessment. Arch Surg 1981; 116: 1416–22.

36.

Kent

Salvatierra

Reilly

Ehrenfeld

Goldstone

Stoney

. Evolving strategies for the repair of complex renovascular lesions. Ann Surg 1987; 206: 272–8.

37.

Murray

Kent

Salvatierra

Stoney

. Complex branch renovascular disease: Management options and late results J Vasc Surg 1994; 20: 338–45.

38.

Onat

Zeren

Coarctation of the abdominal aorta. Review of 91 cases. Cardiologia 1969; 54: 140–57.

39.

Messina

Goldstone

Ferrell

Reilly

Ehrenfeld

Stoney

. Middle aortic syndrome. Effectiveness and durability of complex arterial revascularization techniques. Ann Sure 1986; 204: 331–9.

40.

Graham

Zelenock

Erlandson

Coran

Lindenauer

Stanley

. Abdominal aortic coarctation and segmental hypoplasia. Surgery 1979; 86: 519–29.

The Case for Renal Revascularization

Abstract

Keywords

Get full access to this article

References