Splenorenal bypass in the treatment of renal artery stenosis: Experience with sixty-nine cases

Abstract

From 1962 to 1984 splenorenal bypass was performed in 69 patients with renal artery disease caused by either atherosclerosis (n = 54) or fibrous dysplasia (n = 15). Renal revascularization was performed to control hypertension in 27 patients, to preserve renal function in nine patients, and for both of these reasons in 33 patients. The mean follow-up interval is 5.4 years. Postoperatively hypertension was cured or improved in 52 of 60 patients (87%); the serum creatine level was improved or stable in 37 of 42 patients (88%) who underwent revascularization to preserve renal function. Postoperative graft thrombosis (n = 2) or stenosis (n = 3) occurred in five patients (7%). Splenorenal bypass is an excellent method of revascularization of the left renal artery, particularly for patients with a troublesome aorta that precludes performance of an aortorenal bypass.

Arterial Hypertension in a Child with Williams-Beuren Syndrome (7q11.23 Chromosomal Deletion)

“…The treatment of stenosis of the renal artery performed with splenorenal bypass has a good evolution 33 , and was the treatment proposed for this patient with arterial hypertension refractory to clinical treatment and left renal impairment. The patient evolved uneventfully in the postoperative period, and a reduction in blood pressure levels was observed at a 3-month follow-up.…”

Splenorenal graft: A safe and effective treatment for renovascular hypertension

“…[ 5 ] Since that time scattered reports have appeared, the largest of which is survey by Khauli et al . [ 6 ] Kaufman[ 7 ] and Myers and Johnson found it technically challenging;[ 8 ] however, reports by Brewster et al . show that it is a simple and safe procedure.…”

Splenorenal Arterial Bypass: Description of Technique and Case Example in an Instance of Renal Revascularization during Adrenalectomy for Adrenocortical Carcinoma

“…1 This traditionally and most often was employed to treat renovascular hypertension secondary to renal artery stenosis. [1][2][3] It also was employed, after both blunt and penetrating trauma to the abdomen, as a salvage procedure to preserve renal function. Other reported applications included treatment of bilateral renal artery injury if only one kidney was present, repair of a solitary arterial injury by simple lateral arteriorrhaphy, 4 and correction of a renal artery rupture during percutaneous transluminal angioplasty.…”

“…5 Splenorenal arterial bypass may be an advantageous alternative for renal revascularization, particularly, in patients with an aorta that precludes an aortorenal bypass. 2 Such patients include those whose cardiac dysfunction might be exacerbated by aortic clamping, those who have undergone previous aortic graft placement, 3 and those with severely atherosclerotic aortic walls.…”