Revascularization of the chronic totally occluded renal artery with restoration of renal function.

Nine patients with non-functioning kidneys and complete renal artery occlusion discovered on arteriographic investigation for hypertension underwent renal artery revascularization with successful restoration of renal blood flow. Of these patients 7 experienced recovery of renal function and 2 showed no evidence of improvement. One patient had a creatinine clearance of 38 cc per minute from the revascularized kidney 2 years postoperatively. Predictive determinants of salvageable renal parenchyma were the histologic evidence of intact viable glomeruli and the angiographic features of a rich perihilar collateral circulation in the presence of a proximal occlusion with a patent distal renal artery.