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- Title
Hepatorenal Bypass for Renal Salvage: A Forgotten Option in the Endovascular Era.
- Authors
Salahia, M. Ghali; White, Richard D.; Gordon, Andrew C.; Williams, Ian M.
- Abstract
Introduction: In this era of rapidly expanding endovascular techniques, the use of hepatorenal bypass as treatment for a critically compromised renal perfusion has largely been forgotten. This article highlights the benefits of the technique both as a bailout strategy following complications from angioplasty and as a primary treatment in cases deemed unsuitable for endovascular intervention. Materials and Methods: Two patients are described whose renal viability was threatened by vascular compromise. One patient had a single functioning kidney with significant renal artery stenosis secondary to severe atherosclerotic disease and developed acute renal function deterioration following unsuccessful angioplasty. The second patient developed renal artery occlusion 3 years following open thoracoabdominal aortic aneurysm surgery. Both patients underwent successful hepatorenal bypass surgery and remain off dialysis 6 months after admission. Results: Both cases demonstrated the success of hepatorenal bypass with significant improvement in their renal function following open surgical repair. Conclusion: Hepatorenal bypass, although now seldom used because of available endovascular alternatives, remains an effective method of treating complicated cases of threatened kidney secondary to vascular insult.
- Subjects
ATHEROSCLEROSIS complications; ANGIOPLASTY; ENDOVASCULAR surgery; HEMODIALYSIS; KIDNEY diseases; RENAL artery obstruction; SURGICAL complications; TREATMENT effectiveness; SALVAGE therapy; THORACIC aneurysms
- Publication
Vascular & Endovascular Surgery, 2018, Vol 52, Issue 8, p629
- ISSN
1538-5744
- Publication type
Article
- DOI
10.1177/1538574418779468