Aortic stent and renal autotransplantation for the management of renovascular hypertension with Takayasu's arteritis: Report of a case
Division of Transplantation and Vascular Surgery, Department of Surgery, Kyungpook National University School of Medicine, 200, Dongduk-ro, Jung-gu, Daegu, 700-721, South Korea.Surgery Today (Impact Factor: 1.53). 03/2013; 44(5). DOI: 10.1007/s00595-013-0532-6
Takayasu's arteritis (TA) is a rare inflammatory disease affecting the aorta and its major branches. In patients with TA, middle aortic syndrome with aortic and renal artery involvement causes severe hypertension that does not respond well to medical therapy. Currently, the optimal therapeutic options have not been established, and the reported results of different treatments vary widely. We herein present a case of middle aortic syndrome with renovascular hypertension caused by TA in a 12-year-old male treated by an aortic stent and renal autotransplantation as a two-staged procedure.
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ABSTRACT: Aorto-renal bypass is an effective and durable therapy for autoimmune-induced renovascular hypertension. However, when technical and patient factors preclude this option, renal auto-transplantation can be a viable alternative. We present a 32 year-old female who underwent aorto-bi-iliac bypass with left renal auto-transplantation for malignant hypertension secondary to Takayasu's Arteritis. This is the first description of using machine preservation with a continuous pulsatile perfusion pump to maintain renal preservation before re-implantation. Our method proved safe to the patient and allowed for protection of the organ from prolonged warm ischemia and intra-operative hypoperfusion during a complex reconstruction.
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