scholarly journals Long-term safety of left renal vein division and ligation to expedite complex abdominal aortic surgery

2009 ◽  
Vol 50 (3) ◽  
pp. 500-504 ◽  
Author(s):  
Russell H. Samson ◽  
Michael R. Lepore ◽  
David P. Showalter ◽  
Deepak G. Nair ◽  
Julien B. Lanoue
1974 ◽  
Vol 127 (5) ◽  
pp. 552-554 ◽  
Author(s):  
Thomas S. Royster ◽  
Lawrence Lacey ◽  
Richard A. Marks

2001 ◽  
Vol 15 (6) ◽  
pp. 703-708 ◽  
Author(s):  
Christos D. Karkos ◽  
Iain A. Bruce ◽  
George J.L. Thomson ◽  
Mark E. Lambert

2021 ◽  
pp. 153857442110103
Author(s):  
Thomas Lovelock ◽  
Geoffrey Cox ◽  
Sharmila Balanathan ◽  
Charles Milne

Ligation of the left renal vein is an accepted manoeuvre where it is difficult to access the pararenal abdominal aorta for the open treatment of aortic occlusive or aneurysmal disease. There is some controversy regarding the long-term effect of this on renal function. We describe the case of a 37-year-old gentleman who underwent an elective aorto-bifemoral bypass for aorto-iliac occlusive disease with symptoms of short distance claudication, with intra-operative ligation of the left renal vein. This was complicated by post-operative acute renal failure and haematuria, with CT findings of left renal venous dilatation and peri-renal stranding. The patient underwent successful left renocaval bypass with reversed great saphenous vein, with subsequent resolution of haematuria and improvement in renal function. The syndrome of acute renal failure and haematuria is a rare but possible complication of left renal vein ligation during aortic surgery, and restoration of renal venous outflow via renocaval bypass in this instance was an effective method of treating this complication.


2020 ◽  
pp. 028418512097184
Author(s):  
Hyoung Nam Lee ◽  
Dongho Hyun ◽  
Kwang Bo Park ◽  
Young Soo Do ◽  
Dong-Ik Kim ◽  
...  

Background The rationale behind left renal vein division (LRVD) is the assumption that adequate collateral draining channels will develop. Purpose To describe computed tomography (CT) findings after LRVD during aortic surgery. Material and Methods Among 61 consecutive patients who underwent LRVD during aneurysm repair or revascularization for aortic occlusive disease between January 2003 and December 2017, 51 patients (40 men, mean age 71.4 ± 8.4 years) were enrolled. Contrast-enhanced CT images were analyzed to evaluate collateral drainage, patency, left renal vein diameter, and left renal parenchymal thickness. A total of 115 radiologic reports were reviewed to check whether these findings were accurately mentioned. Results The median time period of the first postoperative follow-up CT was 36 days (range 7–1351 days). The gonadal vein (n = 47) was the most common collateral draining channel, followed by the retroperitoneal veins (n = 42) and adrenal vein (n = 33). Thrombosis occurred in five patients between postoperative days 7 and 17 in the remnant renal vein (n = 3), remnant renal vein plus gonadal and adrenal veins (n = 1), and gonadal vein (n = 1). There was a significant decrease in renal vein diameter (–0.48 ± 2.12 mm, P = 0.006). There was no significant difference in parenchymal thickness (−0.25 ± 1.27 mm, P = 0.193). Neither LRVD nor any associated findings were correctly stated on radiologic reports. Conclusion Postoperative contrast-enhanced CT can delineate collateral draining channels and complications following LRVD. However, these findings tend to be either missed or misinterpreted.


2017 ◽  
Vol 89 (6) ◽  
pp. 26-30 ◽  
Author(s):  
Henryk Sośnik ◽  
Katarzyna Sośnik

Summary: The aim of the study was to determine the incidence of renal venous system congenital anomalies in the Polish population. Material and method: Vascular kidney samples were investigated by means of preparations and X-ray contrasting. The study the group comprised 281 male and 269 female specimens. Results: Congenital anomalies were diagnosed in 186 patients (33 8% of all cases), and they were more frequent in men than in women, albeit that difference was non-significant. The following anomalies were most commonly observed: multiple venous variations on the right side (20.4%), retroaortic course of the left renal vein (4.2%), and circumaortic venous ring of the left renal vein (3.8%). Other anomalies were diagnosed in 1%-2% of cases. Conclusions: Awareness and preoperative assessment of the venous system before abdominal aortic surgery, isolated collection of renal venous blood samples, and urological or kidney transplantation procedures is essential.


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