Ex vivo renal artery reconstructions: Indications and techniques

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Presentation transcript:

Ex vivo renal artery reconstructions: Indications and techniques Richard H. Dean, M.D., Patrick W. Meacham, M.D., Fred A. Weaver, M.D. Journal of Vascular Surgery Volume 4, Issue 6, Pages 546-552 (December 1986) DOI: 10.1016/0741-5214(86)90167-9 Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 Demonstration of patient positioning and site of incision for flank approach to right kidney and renal vasculature. Journal of Vascular Surgery 1986 4, 546-552DOI: (10.1016/0741-5214(86)90167-9) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 Demonstration of use of renal vein occlusion and proximal cannulation. Note that kidney is completely mobilized for ex vivo reconstruction and is connected only by occluded renal vein and ureter. Journal of Vascular Surgery 1986 4, 546-552DOI: (10.1016/0741-5214(86)90167-9) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 Drawing of autotransplanted kidney after ex vivo renal artery reconstruction. Renal vein anastomosis is performed first. Note that in this example the hypogastric artery has been mobilized and divided at branch level for attachment to renal artery branches. Journal of Vascular Surgery 1986 4, 546-552DOI: (10.1016/0741-5214(86)90167-9) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 Demonstration of placement of partially occluding clamp on the vena cava and excision of ellipse of vena cava wall with renal vein origin; this allows reattachment without concern for renal vein anastomotic stenosis. Journal of Vascular Surgery 1986 4, 546-552DOI: (10.1016/0741-5214(86)90167-9) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 Drawing of replaced kidney after completion of ex vivo repair and repositioning of kidney into renal fossa. Note that Gerota's capsule is reattached to provide stability to replaced kidney. Journal of Vascular Surgery 1986 4, 546-552DOI: (10.1016/0741-5214(86)90167-9) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 6 Preoperative (A) and postoperative (B) arteriogram in a 25-year-old white woman who had a congenital solitary right kidney with multiple aneurysms of the right renal artery separately involving each of the branches. Ex vivo repair and replacement into the renal fossa were performed. Journal of Vascular Surgery 1986 4, 546-552DOI: (10.1016/0741-5214(86)90167-9) Copyright © 1986 Society for Vascular Surgery and North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions