Renal artery revascularization in combination with infrarenal aortic reconstruction

Associated stenosis of one or both renal arteries is not uncommon in patien ts with infrarenal aortic disease (aneurysm or occlusive disease) requiring surgical repair. The purpose of this retrospective study was to analyze th e short- and long-term outcome of concomitant renal artery and aortic recon struction. The present series includes 39 consecutive concomitant procedure s. Simultaneous aortic and renal artery reconstruction was performed in a t otal of 39 (7.2%) of the 540 patients who underwent elective infrarenal abd ominal aortic repair between 1987 and 1996. There were 33 men and 6 women w ith a mean age of 66.7 years. Twenty-eight patients presented hypertension and 7 presented renal insufficiency associated with hypertension. In all ca ses, the indication for operative treatment was aortic disease, i.e., aorti c aneurysm in 20 cases and occlusive aortoiliac disease in 19 cases. A tota l of 51 renal artery revascularization procedures were performed, including bypass in 40 cases, transposition in 7, and endarterectomy in 4. Combined aortic and renal artery reconstruction gives good short- and long-term resu lts comparable to those of isolated aortic surgery. On the basis of these f indings, we think that concomitant repair is the strategy of choice for pat ients presenting renal artery stenosis associated with infrarenal aortic di sease requiring surgical therapy.