PMID- 11803264
OWN - NLM
STAT- MEDLINE
DCOM- 20020226
LR  - 20191210
IS  - 0042-1138 (Print)
IS  - 0042-1138 (Linking)
VI  - 68
IP  - 1
DP  - 2002
TI  - Surgery for renovascular diseases: a single-center experience in revascularizing 
      renal artery stenosis and aneurysm.
PG  - 24-31
AB  - OBJECTIVE: Diagnosis and management of renovascular diseases (RVD) at Hokkaido 
      University Hospital was reviewed with particular emphasis on surgical 
      revascularization (SR). PATIENTS AND METHODS: We studied a total of 33 patients 
      with RVD [16 patients with renal artery stenosis (RAS): group 1, and 17 patients 
      with renal artery aneurysm (RAA): group 2, 10 males, 23 females, aged 9-69 years 
      (median 46), unilateral 24, bilateral 9]. Functional diagnosis of RVD with regard 
      to renovascular hypertension (RVH) was done with the captopril test (CP-T) and 
      captopril-enhanced (99m)Tc-DTPA (diethylenetriamine-pentaacetic acid) renal 
      scintigraphy (CER). All were subjected to SR. Number, length, size and site of 
      RVD with involvement of branch arteries dictated the choice of operative method 
      but basically in situ repair for main trunk disease (11 kidneys) and ex vivo 
      bench repair with autotransplantation for those beyond the first bifurcation 
      intrarenally involving branched arteries (24 kidneys) were employed. The outcome 
      was analyzed as to blood pressure control, split renal function, and branch renal 
      artery patency. RESULTS: (1) Sensitivity of CP-T and CER was 79 and 77% 
      respectively in group 1, while it was 40 and 38% respectively in group 2. (2) 
      Blood pressure was cured in 66.7% (group 1, 68.8% and group 2, 63.6%) and 
      improved in 22.2% (group 1, 18.8% and group 2, 27.3%) with an overall success 
      rate of 88.9%. (3) Renal function was good in 81.3% (group 1, 83.3% and group 2, 
      78.6%) and fair in 9.4% (group 1, 0% and group 2, 21.4%) with overall success in 
      90.7%. (4) Patency was preserved in 90.5% of branch anastomoses. CONCLUSIONS: 
      Despite challenging complexities, SR of RVD is feasible with a reasonable amount 
      of morbidity and effective in controlling blood pressure and preserving renal 
      function in the majority of cases.
CI  - Copyright 2002 S. Karger AG, Basel
FAU - Koyanagi, Tomohiko
AU  - Koyanagi T
AD  - Department of Urology, Hokkaido University Hospital, Sapporo, Japan. 
      tomohiko@med.hokudai.ac.jp
FAU - Nonomura, Katsuya
AU  - Nonomura K
FAU - Takeuchi, Ichiro
AU  - Takeuchi I
FAU - Watarai, Yoshihiko
AU  - Watarai Y
FAU - Seki, Toshimori
AU  - Seki T
FAU - Kakizaki, Hidehiro
AU  - Kakizaki H
LA  - eng
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PL  - Switzerland
TA  - Urol Int
JT  - Urologia internationalis
JID - 0417373
RN  - 9G64RSX1XD (Captopril)
RN  - VW78417PU1 (Technetium Tc 99m Pentetate)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aneurysm/*diagnosis/*surgery
MH  - Angiography/methods
MH  - Captopril
MH  - Child
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Japan
MH  - Kidney Function Tests
MH  - Male
MH  - Middle Aged
MH  - Radionuclide Imaging/methods
MH  - *Renal Artery
MH  - Renal Artery Obstruction/*diagnosis/*surgery
MH  - Retrospective Studies
MH  - Technetium Tc 99m Pentetate
MH  - Treatment Outcome
MH  - Vascular Patency
MH  - Vascular Surgical Procedures/*methods
EDAT- 2002/01/23 10:00
MHDA- 2002/02/28 10:01
CRDT- 2002/01/23 10:00
PHST- 2002/01/23 10:00 [pubmed]
PHST- 2002/02/28 10:01 [medline]
PHST- 2002/01/23 10:00 [entrez]
AID - uin68024 [pii]
AID - 10.1159/000048413 [doi]
PST - ppublish
SO  - Urol Int. 2002;68(1):24-31. doi: 10.1159/000048413.