Splenorenal bypass in the treatment of renal artery stenosis: experience with sixty-nine cases.

From 1962 to 1984 splenorenal bypass was performed in 69 patients with renal artery disease caused by either atherosclerosis (n = 54) or fibrous dysplasia (n = 15). Renal revascularization was performed to control hypertension in 27 patients, to preserve renal function in nine patients, and for both of these reasons in 33 patients. The mean follow-up interval is 5.4 years. Postoperatively hypertension was cured or improved in 52 of 60 patients (87%); the serum creatine level was improved or stable in 37 of 42 patients (88%) who underwent revascularization to preserve renal function. Postoperative graft thrombosis (n = 2) or stenosis (n = 3) occurred in five patients (7%). Splenorenal bypass is an excellent method of revascularization of the left renal artery, particularly for patients with a troublesome aorta that precludes performance of an aortorenal bypass.