Safety and efficacy of transaortic renal endarterectomy as an adjunct to aortic surgery

J Vasc Surg. 1995 Jun;21(6):926-33; discussion 934. doi: 10.1016/s0741-5214(95)70220-2.


Purpose: A study was undertaken to assess the safety and efficacy of transaortic endarterectomy for orificial atherosclerotic renovascular disease (ASRD), particularly in conjunction with surgery for concomitant aortic disease.

Methods: Forty-three consecutive patients with ASRD treated with transaortic orificial eversion endarterectomy were studied retrospectively to identify surgical indications, technical features, operative morbidity and mortality rates, and efficacy.

Results: A total of 76 renal arteries underwent transaortic endarterectomy for hypertension (88% of patients) or serum creatinine of 1.5 mg/dl or greater (65% of patients), including two patients undergoing dialysis. Concomitant aortic surgery was performed in 39 patients for aneurysmal (n = 30) or occlusive (n = 9) disease. Two (2.6%) of 76 renal endarterectomies required intraoperative conversion to bypass because of poor flow, and three arteries (3.9%) were reimplanted or bypassed because of fragility of the renal orifice after endarterectomy. Thirty-day operative death occurred in two patients (4.7%), and major morbidity occurred in six (14.0%). Hypertension was cured or improved in 83% of patients with hypertension. Among patients with preoperative renal insufficiency, function was improved in 19%, with dialysis discontinued in one of two patients receiving dialysis, and function was worse in 23%, with one patient dependent on dialysis.

Conclusion: Transaortic renal endarterectomy is an acceptably safe and effective adjunctive technique in selected patients with combined aortic disease and ASRD.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aorta, Abdominal / surgery*
  • Aortic Diseases / complications
  • Aortic Diseases / surgery
  • Arteriosclerosis / surgery*
  • Endarterectomy / methods*
  • Female
  • Humans
  • Intraoperative Complications
  • Male
  • Middle Aged
  • Postoperative Complications / mortality
  • Renal Artery / surgery*
  • Renal Artery Obstruction / complications
  • Renal Artery Obstruction / surgery*
  • Retrospective Studies