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Objective to prevent kidney injury in renal artery and juxta-renal aortic surgery. After 30 min of cross-clamping ischaemia, renal arterial inflow is temporary re-established for 3 min. The aim of the study was to retrospectively analyse the results of this original technique. Methodsbetween January 1987 and May 1999, 48 patients underwent kidney short-term arterial blood reperfusion, directly or through the Pruitt–Inahara shunt. The reperfusion was repeated every 30 min of ischaemia, whenever necessary. Fifty control patients underwent <30 min of kidney ischaemia. Patients were assessed by serum creatinine, digital angiography and radioisotope renography using technecium99. Resultsin the study group one patient developed an acute renal failure and died (2% (−95% CI: 0–11%)). In both study and control groups patients showed a similar and moderate but temporary decline in renal function, which returned to preoperative levels after 1 week. Conclusionsthe results of this study indicate that kidney short-term reperfusion may protect renal tissue from prolonged cross-clamping ischaemia (up to 100 min), also in patients considered at high risk for acute renal failure.

Objectives:to determine whether duplex ultrasonography alone is an adequate examination prior to carotid endarterectomy. Design:prospective, randomised, single centre study. Material and Methods:all patients with carotid bifurcation stenosis greater than 70% – based on duplex scanning – were randomised to arteriography followed by carotid surgery (Group A n=96) or cartid surgery alone (Group B n=90). Study endpoints were neurological complications or death occurring between the day of randomisation and until 30 days after surgery. Results:major neurological complications of death in 1 (1%) vs 3 (3.3%) patients in group A and B, respectively (n.s.). Minor neurological complications (only TIA) were observed in 0 and 3 (3.3%) patients, respectively. Conclusions:complication rates were low in both groups and within the generally accepted rate after carotid surgery in asymptomatic and symptomatic patients.