Ex Situ Repair of Renal Artery for Renovascular Hypertension

Abstract

RENOVASCULAR hypertension is usually treated with an implantation of either bypass graft or patch graft. This method has been successful to some extent.¹ However, we are not completely satisfied with it. The failures seem to have arisen from the fact that the renal artery lies deep in retroperitoneal space. Especially on the right side, the renal artery runs behind the inferior vena cava and this hinders delicate surgical manipulation. Not rarely the failure to establish sufficient blood flow in the renal artery ultimately leads to nephrectomy. Needless to say, reconstruction of the artery necessitates a precise technique. It is not recommended that such a maneuver be performed in a restricted surgical field or even behind the inferior vena cava which is vulnerable to factitial injury. Recent advancement in renal homotransplantation has shown that the nephrectomized kidney functions well after transplantation.² It therefore occurred to us that the kidney