Patterns of Collateral Flow in Renal Ischemia

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Abstract
The presence of collateral vessels to the kidney in obstructive renal artery disease has been noted both in animals and in man. Nevertheless, the pattern of the collateral circulation has not been studied in detail, and it has been correctly stated that “little is known of the extrarenal collateral arterial circulation in man” (6). Our interest in this problem. prompted us to analyze the pathways of collateral flow. Methods and Materials Four dogs were subjected to a right nephrectomy, followed a week later by application of a Goldblatt clamp to the left renal artery.3 About seven weeks after the second procedure, when hypertension had developed in all animals, left renal arteriography was performed, utilizing percutaneous transfemoral intra-aortic catheterization. Ten cubic centimeters of 76 per cent Renografin was injected into the aorta with a mechanical injector in about three-fourths of a second. Observations were made in 24 clinical subjects with main renal artery stenosis and collateral channels. I...

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