Clinical observations

doi: 10.25005/2074-0581-2017-19-1-125-128
THE CASE OF SUCCESSFUL RENAL REVASCULARIZATION BY THE METHOD OF AORTORENAL SHUNTING

A.D. Gaibov1, О. NEMATZODA2, D.D. Sultanov1, T.G. Gulmuradov1, F.S. Tohirov2

1Avicenna Tajik State Medical University, Dushanbe, Tajikistan
2Public Institution «Republican Scientific Center of Cardiovascular Surgery», Dushanbe, Tajikistan

The article describes the case of successful revascularization of the right kidney by the method of autovenous aortorenal shunting. According to the data of renal duplex scanning, the patient showed signs of a size reducing of the right kidney with a decrease in blood flow velocity and resistance indices in the renal artery. Results of spiral computed tomography demonstrated the subtotal stenosis of the right renal artery up to 95% and preservation of the excretory function of the kidney. During the angiography an occlusion of the proximal segment of the right renal artery was detected, and an attempt of recanalization for subsequent stenting was failed. As a consequence, an open revascularization – autovenous aortorenal shunting was performed using laparotomy access. In the short- and mid-term periods, normalization of arterial pressure and satisfactory patency of the autovenous shunt were noted. In the opinion of the authors, in case of obliteration of the proximal segment of the renal artery caused by arteritis, open revascularization is a procedure of choice that provides radical restoration of the main blood circulation of the organ.

Keywords: Stenosis of the renal artery, vasorenal hypertension, aortorenal shunting.

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References
  1. Arakelyan VS, Gidaspov NA, Kolesnikov YaG, Gamzaev NR, Shumilina MV, Bortnikova NV, i dr. Kriticheskiy stenoz arterii edinstvennoy funktsioniruyushchey pochki: otkrytaya hirurgiya ili stentirovanie – kakova raznitsa? [Critical artery stenosis of a single functioning kidney: open surgery or stenting – what is the difference?] Klinicheskaya fiziologiya krovoobrashcheniya [Clinical physiology of circulation]. 2013;3:65-71.
  2. Hirsch AT, Haskal ZJ, Hertzer NR. ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Associations for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease) – summary of recommendations. J Vasc Interv Radiol. 2006;17:1383-97.
  3. Viera AJ, Neutze DM. Diagnosis of Secondary Hypertension: An Age-Based Approach. Am Fam Physician. 2010;82(12):1471-8.
  4. Kalmykov EL, Sadriev ON. Nespetsificheskiy aorto-arteriit (bolezn’ Takayasu) [Nonspecific aorto-arteriitis (Takayasus disease)]. Nauka molodykh (Eruditio Juvenium) [Science of the young (Eruditio Juvenium)]. 2015;4:127-33.
  5. Belov YuV, Komarov RN, Gaibov AD, Turaev MM. Uspeshnoe lechenie gipoplazii torakoabdominal’noy aorty [Successful treatment of thoracoabdominal aortas hypoplasia]. Avicenna Bulletin (Vestnik Avitsenny). 2012;4(53):96-101.
  6. Sahin S, Cimsit C, Andac N. Renal artery stenting in solitary functioning kidneys: technical and clinical results. Eur J Radiol. 2006;57:131-7.
  7. Wheatley K, Phil D, Ives N. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med. 2009;361:1953-62.

Authors informations:

Gaibov Alidjon Djuraevich, Doctor of Medical Sciences, Full Professor, Corresponding Member of Academy of Medical Sciences of Ministry of Health and Social Protection of Population of the Republic of Tajikistan, Professor at the Department of Surgical Diseases № 2 at Avicenna Tajik State Medical University;

Nematzoda Okildjon, Candidate of Medical Sciences, Leading Researcher of the Republican Scientific Center of Cardiovascular Surgery;

Sultanov Djavli Davronovich, Doctor of Medical Sciences, Full Professor, Professor at the Department of Surgical Diseases № 2 at Avicenna Tajik State Medical University;

Gulmuradov Tashpulat Gulmuradovich, Doctor of Medical Sciences, Full Professor, Corresponding Member of Academy of Medical Sciences of Ministry of Health and Social Protection of Population of the Republic of Tajikistan, Research Supervisor of the Republican Scientific Center of Cardiovascular Surgery;

Tohirov Firdavs Samievich, candidate for a degree at Republican Scientific Center of Cardiovascular Surgery

Address for correspondence:

Gaibov Alidjon Djuraevich

Doctor of Medical Sciences, Full Professor, Corresponding Member of Academy of Medical Sciences of Ministry of Health and Social Protection of Population of the Republic of Tajikistan, Professor at the Department of Surgical Diseases № 2 at Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Avenue, 139

Tel.: (+992) 918 470017

E-mail: gaibov_a.d@mail.ru

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