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Biomedical subjects

A C Novick

Publications and source records attributed to A C Novick.

At least 397 records · Page 22Linked to original sources
PubMed1979

Atherosclerotic renal artery occlusion extending into branches: successful revascularization in situ with a branched saphenous vein graft.

In some patients successful renal revascularization can be done after complete renal artery occlusion. We report on a patient with atherosclerotic occlusion of the renal artery and its branches in whom an aortorenal bypass with a branched saphenous vein graft was performed in situ, with cure of hypertension and reversal of azotemia. This is a useful and versatile technique for replacing the renal artery and its major branches.

Arteriosclerosis↗
PubMed1979

Multiple-artery renal transplantation: emphasis on extracorporeal methods of donor arterial reconstruction.

The operative techniques to transplant kidneys with multiple renal arteries and our recent experience with them are reviewed. The preferred methods are anastomosis with a Carrel aortic patch and extracorporeal arterial repair before transplantation. These are simple and effective methods that avoid subjecting the kidney to prolonged ischemia. Revascularization of all renal arteries is important to obviate ischemic allograft complications.

Humans↗
PubMed1979

Aortorenal bypass with a branched saphenous vein graft for renal artery disease extending into the branches.

Improved vascular reconstructive techniques now enable renal revascularization in patients with extensive renovascular disease. Two patients are reported who underwent aortorenal bypass with a branched saphenous vein graft for disease involving the main renal artry and its major segmental branches. This technique represents an excellent means of achieving successful renal revascularization in some patients with branch renal artery disease.

Adult↗
PubMed1979

Experimental and clinical hepatorenal bypass as a means of revascularization of the right renal artery.

In patients with severe atherosclerosis of the abdominal aorta or previous operations on the abdominal aorta, right renal revascularization may be difficult to achieve using aortorenal bypass. An experimental study was performed demonstrating the efficacy of hepatorenal bypass as an alternative operative procedure in this regard. Follow-up studies in these dogs demonstrated no adverse postoperative effects on hepatic function or morphology. In addition, two patients underwent hepatorenal bypass with a saphenous vein graft as surgical treatment for azotemia and hypertension caused by atherosclerotic right renal artery stenosis. Postoperatively, the blood pressure diminished and renal function improved in both patients. No evidence of persistent hepatic dysfunction was observed.

Animals↗
PubMed1978

Experimental bladder substitution using a biodegradable graft of natural tissue.

A controlled canine experimental study has been performed to test the application of a biodegradeable graft to vesical augmentation. The graft, after providing initial bladder enlargement, is progressively reabsorbed while serving as a foundation for the regeneration and healing of the layers of the bladder remnant. Follow-up studies at 1 year revealed no urinary infection, calculi, extravasation of urine, or rejection of the material. Normal bladder capacities were maintained throughout the study and the reconstructed bladders functioned normally. The biodegradable graft was equally successful when applied either to a histologically normal bladder remnant, or to a pathological bladder of intramural fibrosis. These results suggest that this material may be well suited to clinical bladder substitution in humans.

Animals↗
PubMed1978

Surgery for renal cell carcinoma extending into the inferior vena cava.

We have reviewed 26 patients with renal cell carcinoma extending into the inferior vena cava, 21 of whom underwent radical nephrectomy with either venacavotomy and tumor thrombectomy, or vena cava resection. Of 12 patients who presented with localized neoplasm 6 (50 per cent) are currently alive. Poor results were obtained in 9 patients who had preoperative metastatic disease. Over-all operative mortality was 14 per cent and morbidity was minimal, with no pulmonary emboli intraoperatively or postoperatively.

Adenocarcinoma↗
PubMed1978

Surgical treatment of renovascular hypertension in the pediatric patient.

Of 27 children who underwent surgical treatment for renovascular hypertension 16 (59 per cent) were cured, 5 (19 per cent) were improved and 6 (22 per cent) were failures. Improved results were obtained in patients with unilateral renal artery stenosis. Several reconstructive vascular procedures were used, and their relative efficacy and indications are discussed. Renovascular hypertension in children is a curable disease and revascularization with preservation of renal parenchyma should be the aim of surgical therapy in most cases.

Adolescent↗
PubMed1978

Stenosing renal artery disease in children: clinicopathologic correlation and results of surgical treatment.

From 1955 to 1977, 27 pediatric patients underwent surgical treatment for renovascular hypertension. Renal artery disease was most commonly caused by intimal or perimedial fibroplasia and occurred bilaterally in 7 patients. Overall results were 16 patients cured (59%), 5 patients improved (19%) and 6 failures (22%). The best results were obtained in children with unilateral renal artery stenosis. In recent years, ablative surgery has been largely supplanted by reconstructive vascular procedures in the treatment of this disease in children. Autogenous vascular bypass grafts have been most successful and aortorenal reimplantation may occasionally be employed. Renal autotransplantation should be reserved for children with the middle aortic syndrome or multiple lesions involving the branches of the renal artery. Splenorenal bypass and segmental resection with renastomosis have yielded poor results and are best avoided in this age group. Primary nephrectomy should only be performed in patients with renal atrophy or uncorrectable branch vessel disease. Renovascular hypertension in children is a potentially curable disease and revascularization with preservation of renal function should be the combined objectives of surgical therapy in the most cases.

Adolescent↗
PubMed1977

Experimental bladder substitution using biodegradable graft of natural tissue.

A controlled experimental study has been performed using a biodegradable graft of natural tissue to achieve vesical augmentation. The graft is progressively reabsorbed while normal capacity is maintained by concomitant regeneration of the layers of the bladder remnant. No significant complications were encountered, and the graft was equally successful when applied either to a histologically normal bladder or to a pathologic bladder of intramural fibrosis. This material is potentially ideal for clinical bladder substitution in humans.

Animals↗
PubMed1977

Autogenous arterial grafts in the treatment of renal artery stenosis.

Twenty-three patients who underwent renal revascularization with autogenous arterial bypass grafts for renovascular hypertension are reviewed. The arterial autograft consisted of the hypogastric artery in 19 cases and a free splenic artery graft in 4. Eighteen patients were cured (78 per cent), 4 improved (18 per cent) and there was 1 failure (4 per cent). There were no cases of graft stenosis or occlusion. Postoperative morbidity was minimal and there was no operative mortality. When such grafts are available they provide an excellent means to achieve successful long-term renal revascularization.

Adolescent↗
PubMed1977

Partial nephrectomy in the treatment of renal adenocarcinoma.

During a 20-year period 17 patients underwent partial nephrectomy as primary curative therapy for renal adenocarcinoma. In 15 patients (88 per cent) partial nephrectomy was performed satisfactorily in situ with free margins of resection. Eleven patients are alive (65 per cent) and only 3 (17 per cent) died of recurrent malignant disease. There was no operative mortality and postoperative complications were minimal. A review of the literature reveals that partial nephrectomy is an effective form of therapy for patients with bilateral renal carcinoma or carcinoma occurring in a solitary kidney.

Adenocarcinoma↗
PubMed1977

Renal revascularization in patients with severe atherosclerosis of the abdominal aorta or a previous operation on the abdominal aorta.

Renal revascularization has been performed in six patients in whom severe atherosclerosis or previous operative procedures on the abdominal aorta precluded the performance of a standard aortorenal bypass graft. Splenorenal anastomoses were performed in three patients, superior mesenterorenal anastomosis in one patient, long saphenous vein iliorenal anastomosis in one patient, and renal autotransplantation in one patient. Successful renal revascularization with preservation of renal function was accomplished in all patients. The natural history of severe atherosclerotic renovascular disease has demonstrated the relatively frequent occurrence of arterial thrombosis and renal failure in patients with solitary kidneys. Occasionally, the presence of severe aortic disease precludes the use of standard aortorenal bypass grafting. Fortunately, as reported herein, alternate methods of revascularization are available whereby renovascular hypertension can be corrected and renal function preserved, with minimal operative risk.

Adult↗
PubMed1977

Splenorenal bypass in the treatment of renal artery stenosis.

A retrospective study is presented of our experience from 1962 to 1976 with the splenorenal bypass procedure in the treatment of 32 patients with renovascular hypertension. The over-all results were 53 per cent of the patients cured, 28 per cent improved and 19 per cent failures. Improved results were noted when the splenorenal bypass was performed in relation to specific operative indications. The results were somewhat better in men than in women and poor results were obtained in children. Intraoperative and early postoperative complications were minimal. There were 2 postoperative deaths, for a hospital mortality rate of 6.3 per cent. Late complications were limited to splenic artery graft stenoses, which developed in 3 patients (9.4 per cent). When performed in relation to specific clinical and operative indications the splenorenal bypass is believed to represent an excellent means to achieve safe and effective renal revascularization.

Adolescent↗