Combined Aortic and Renal Artery Reconstruction

James M. Wong and Kimberley J. Hansen Management of renal artery disease discovered incidentally during angiographic

study of the abdominal aorta is controversial. In this setting, the surgeon must address the need for additional diagnostic study and the decision of whether to perform combined aortic and renal artery reconstruction. Data pertaining to this latter deci­ sion may be obtained from a review of the natural history of atherosclerotic renal artery disease compared with the results of combined repair. This information then helps to form a therapeutic plan appropriate to the individual patient. In the follow­ ing discussion, combined management of aortic and renal artery disease will be considered as either a prophylactic or empiric procedure.