Renal artery stenosis and obstruction of aorto-arteritis--a radiologic study of collateral circulation and its function
Zhang, L.R.
Zhonghua Xin Xue Guan Bing Za Zhi 12(3): 184-7 238
1984
ISSN/ISBN: 0253-3758 PMID: 6532760 Document Number: 230723
Renal artery lesion of aortoarteritis is one of the most common etiological diseases causing renovascular hypertension in China. The collateral circulation (CC) of 103 angiographically proved cases of aorto-arteritis with renal artery lesion was studied in this article. In 32 (31%) of the 103 cases the renal artery was involved isolatedly while the remaining 71 cases (69%) were in association with the lesions of aorta and other branches, constituting multiple lesions. In those latter cases, abdominal aorta and superior mesenteric artery were most commonly involved. The total incidence of CC in 103 cases of the present series was 91%. The amount of CC was estimated small and moderate in 31% and extensive in 60%. The occurrence and amount of CC were closely related to the severity and extent of the renal artery lesion, and not to its site. The CC is usually of multiple origin, mainly coming from the extrarenal and perirenal system. The pelvic arterial plexus, the 1st lumbar artery and the ureteral arterial plexus were the most common and important sources of CC in cases of the present series. The angiographic pattern of CC was very complicated in cases with multiple lesions showing the collateral vessels originating both from the visceral and parietal artery system. There is no positive correlation between the presence and extent of CC and the development and severity of hypertension. In some cases, however, CC may relieve and compensate some degree of renal ischemia and atrophy. Collateral circulation (CC) does not play an important role in selecting surgical candidate and predicting prognosis.