Background: The choice of renal revascularization procedure is influen
ced by the site of the stenosis, the patency of the contralateral rena
l artery and the presence of visceral artery disease, particularly of
the coeliac axis. In this study, we reviewed the prevalence of contral
ateral renal artery stenosis, superior mesenteric artery stenosis and
coeliac axis stenoses in patients who had undergone renal revasculariz
ation. Method: The angiograms of 122 patients (57 renal angioplasties
and 65 anatomic and extra-anatomic bypasses performed between 1992 and
1997) were reviewed. Results: All patients had renal artery stenosis
of greater than 50 per cent. Renal artery occlusion was present in 30
per cent of patients, 10 per cent were bilateral. The prevalence of co
ntralateral renal artery stenosis (>50 per cent) was 64 per cent. Sten
oses in either the superior mesenteric artery (SMA) or coeliac axis (C
A) were present in 67 per cent of these patients. Stenosis on the CA w
ere the most frequent (60 per cent of all patients). Stenoses of all f
our vessels (both renal arteries, SMA and CA) were present in 23 per c
ent. Conclusion: This study demonstrates the frequent co-existence of
coeliac axis and contralateral renal artery stenoses. Screening of all
visceral vessels with lateral views of the origins of both SMA and CA
is recommended for the appropriate choice of renal revascularization
procedure.