Acute bilateral renal artery occlusion with prolonged anuria carries a poor prognosis for renal salvage that may prompt insufficiently aggressive management. This case report describes successful redo bilateral renal bypass 19 years after revascularization for fibromuscular dysplasia. The role of the renal collateral network in kidney salvage is discussed as is a life-long, aggressive, physiologic, and anatomic postoperative surveil lance program.
Get full access to this article
View all access options for this article.
References
1.
Alimi Y., Mercier C., Pellissier J., et al: Fibromuscular disease of the renal artery: A new histopathologic classification. Ann Vasc Surg6:220-224, 1992.
2.
Luscher TF, Lie JT, Stanson AW, et al: Arterial fibromuscular dysplasia. Mayo Clin Proc62:931-950, 1987.
3.
Stanley JC, Gewertz BL, Bone EL, et al: Arterial fibrodysplasia. Arch Surg110:561-565, 1975.
4.
Gruntzig A., Kuhlmann U., Vetter W., et al: Treatment of renovascular hypertension with percutaneous transluminal dilatation of a renal-artery stenosis. Lancet1:801-802, 1978.
5.
Tegtmeyer CJ , Selby JB, Hartwell GD, et al: Results and complications of angioplasty in fibromuscular disease. Circulation83 (suppl I):I-155-I-161, 1991 .
6.
Anderson CA, Hansen KJ, Benjamin ME, et al: Renal artery fibromuscular dysplasia: Results of current surgical therapy. J Vasc Surg22:207-216, 1995.
7.
Ouriel K., Andrus CH, Ricotta JJ, et al: Acute renal artery occlusion: When is revascularization justified?J Vasc Surg5:348-355, 1987.
8.
Cragg AH, Smith TP, Thompson BH, et al: Incidental fibromuscular dysplasia in potential renal donors: Long-term clinical follow-up. Radiology172:145-147, 1989.
9.
Ekelund L., Gerlock J., Molin J., et al: Roentgenologic appearance of fibromuscular dysplasia. Acta Radiol Diag19:433-445, 1978.
10.
Foster JH, Dean RH, Pinkerton JA, et al: Ten years experience with the surgical management of renovascular hypertension. Ann Surg177:755-766, 1973.
11.
Abrams HL, Cornell SH: Patterns of collateral flow in renal ischemia. Radiology84:1001-1012, 1965.
12.
Yune HY, Klatte EC: Collateral circulation to an ischemic kidney. Radiology119:539-546, 1976.
13.
Love L., Bush IM: Early demonstration of renal collateral arterial supply. Am J Roentgenol104:296-301, 1968.
14.
Hudspeth DA , Hansen KH, Reavis SW, et al: Renal duplex sonography after treatment of renovascular disease. J Vasc Surg18:381-390, 1993.
15.
Tullis MJ, Zierler RE, Glickerman DJ, et al: Results of percutaneous transluminal angioplasty for atherosclerotic renal artery stenosis: A follow-up study with duplex ultrasonography. J Vasc Surg25:46-54, 1997.
16.
Eidt JF, Fry RE, Clagett GP, et al: Postoperative follow-up of renal artery reconstruction with duplex ultrasound. J Vasc Surg8:667-673, 1988.
17.
Edwards JM, Zaccardi MJ, Strandness DE: A preliminary study of the role of duplex scanning in defining the adequacy of treatment of patients with renal artery fibromuscular dysplasia . J Vasc Surg15:604-611,1992.
