Presence of renal artery stenosis may indicate risk

BMJ 1996;313:750 (21 September)

Letters

Presence of renal artery stenosis may indicate risk

EDITOR,--N Mamode and colleagues' finding of an increased incidenceof perioperative myocardial infarction in patients undergoingperipheral vascular surgery is important.¹ The authors failto point out, however, that these patients, in addition to havingcoronary artery disease, also have generalised vascular disease,which often affects the renal² ³ and carotid arteries. Thismay have important implications in patients undergoing surgeryfor peripheral vascular disease.

Forty two consecutive patients referred to our institution forinvestigation of severe ischaemia of the leg underwent renalangiography at the same time as peripheral angiography. Nineteenof the 42 had renal artery stenosis (mean (SD) serum creatinineconcentration 112 (40) µmol/l; mean age 74 (10)). In the23 patients with no evidence of renal artery stenosis the meanserum creatinine concentration was 97 (23) µmol/l andthe mean age 69 (10)). All patients had elective salvage vascularsurgery for severe pain or gangrene. Of those . . . [Full text of this article]

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Relevant Article

Perioperative myocardial infarction in peripheral vascular surgery: N Mamode, R N Scott, S C McLaughlin, A McLelland, and J G Pollock
BMJ 1996 312: 1396-1397. [Full Text]