Renal artery bypass is a surgical procedure used to restore blood flow to the renal arteries (blood vessels of the kidneys). Reduced blood flow in one or both of the renal arteries can be caused by hardening of the arteries, and is called renal artery stenosis.
These renovascular conditions can lead to high blood pressure and chronic renal disease (slow loss of kidney function).
Why Choose The Ohio State University Wexner Medical Center?
At Ohio State’s Wexner Medical Center, our vascular surgeons are experienced in diagnosing renal artery stenosis, and in all forms of treatment for renal artery stenosis, including minimally invasive angioplasty and stenting, and open surgical bypass or endarterectomy for more complex cases.
Since The Ohio State University Wexner Medical Center is an academic medical center, our patients benefit from innovative research, a depth of medical expertise and the newest technologies and treatment techniques available.
What Is Renal Artery Bypass?
Renal artery bypass is a surgical procedure that creates an alternate route (bypass) for blood to flow around a blockage in your renal arteries. The bypass may be made by harvesting a vein from your leg. It may also be made from prosthetic man-made material. The vessel is then attached above and below the blocked area. Once the bypass is in place, blood circulation to the kidneys is restored.
Prior to proceeding with renal artery bypass, your doctor will conduct a history and physical to determine your symptoms. You may be asked to undergo some tests to determine the amount of narrowing in your vessels. These tests may include:
- CT scan (computed tomography scan, also called CAT scan) – An imaging procedure that uses X-rays and computer technology to produce cross-sectional, detailed images of the body, including bones, muscles, fat and organs.
- Duplex ultrasound – A painless, noninvasive test that shows how blood is moving through your arteries and veins. It examines the structure of your blood vessels and indicates if there are any blockages within your arteries.
- MRA (magnetic resonance angiography) – A noninvasive imaging procedure that uses large magnets, radiofrequencies and a computer to evaluate blood flow through arteries.
If one of these tests demonstrates that your arteries have narrowing, you may be asked to have an angiogram (X-ray of blood vessels to identify blockage).
Why Have Renal Artery Bypass?
When renal artery stenosis develops, the blood vessels narrow, causing reduced blood flow to the kidneys. The kidneys respond as if the blood pressure is low and mistakenly secrete hormones that tell the body to hold on to more salt and water, which causes the blood pressure to rise.
High blood pressure damages the small blood vessels in the kidneys and reduces their ability to filter waste from the blood. Renovascular conditions develop and worsen over time. Without treatment, kidney damage may progress and result in kidney failure.
What to Expect During Renal Artery Bypass
Preparing for Your Procedure
Tell your doctor about all of the medications you are taking, including over-the-counter medications, and also if you are allergic to any medications. You will be asked to refrain from eating or drinking after midnight before the morning of your procedure.
During Your Procedure
Renal artery bypass is a major operation done through an incision in the abdomen. The procedure is done under general anesthesia. During a renal artery bypass, a vessel is created from a vein that is taken from your groin or arm, or it is created from synthetic materials. This vessel is grafted (sewed) above and below the area of blockage in your renal artery, creating an alternate route for blood to flow to the kidneys.
After Your Procedure
You will be closely monitored in the hospital following renal artery bypass. Patients can expect to be in the hospital three to five days after surgery. Return to normal functioning occurs after about a month. Once you return home, you should resume taking your medications unless your doctor instructs otherwise. You will continue to be monitored during periodic follow-up visits.