Results of Surgical Treatment of Patients with Lesions of the Renal Arteries

Valery S. Arakelyan, Nikita A. Gidaspov, Pavel P. Kulichkov, Nikolay A. Chigogidze

A.N. Bakoulev National medical research center for Cardiovascular Surgery, Moscow, Russia

Date, time and location: 2018.05.26 08:30, Exhibition area, 1st Floor. Zone – B

Abstract

The aim of this study was to investigate the results of surgical treatment of patients and the development of tactics of surgical treatment of patients with lesions of the renal arteries.

Materials and methods.

The group of endovascular revascularization. 62 patients (59%) underwent angioplasty and stenting. All patients isolated renal artery stenosis over 70%. The average patient age was 66.2±6.7 years. Among the concomitant diseases: ischemic heart disease at 48.3%, the defeat of the brachiocephalic arteries and a stroke has a history and 12.9%, diabetes in 14.5% of patients.

The group of patients with open reconstruction. In 43 patients (41%) performed open reconstruction of the renal artery. The average age of patients was 38.2±7.4 years. Performed surgery: prosthetics renal artery (51,2%), resection of the stenosis with anastomosis end-to-end or reimplantation (32,5%) and transaortic endarterectomy (16,3%). 7% patients the indication for surgery was also saccular aneurysm of the renal artery. In 7% of patients also made the prosthetics of the infrarenal aorta for aneurysms, at 9.3% of aortofemoral bifurcation bypass surgery.

Results. In-hospital mortality 0. The average length of hospital stay after angioplasty and stenting of 1.19±0,53 days, after open operations of 7.16±1,17 days. In the postoperative period in 2 patients (1,9%) had reperfusion syndrome that required the use of dialysis. In other cases, evidence of progression of renal dysfunction was not noted. Early complications associated with impaired patency of the renal arteries was not observed.

Сonclusions. Angioplasty with stenting is applicable and has good results in patients at high surgical risk, isolated lesion of the renal arteries (mainly ostial stenosis). Open reconstruction is preferable when non-atherosclerotic lesions of the renal arteries, when combined with pathology of the abdominal aorta, aneurysm of the renal artery, and also with previous failed attempts of endovascular correction