Prominent publications by RICHARD H DEAN

KOL Index score: 14528

PURPOSE: The purpose of this investigation was to estimate the population-based prevalence of renovascular disease (RVD), defined as > or = 60% diameter-reducing renal artery stenosis or occlusion, and to define its associations with age, gender, race, and other potential risk factors among participants in the Cardiovascular Health Study (CHS).

METHODS: The CHS is a multicenter, longitudinal cohort study of cardiovascular disease risk factors, morbidity, and mortality among free-living ...

Also Ranks for: Renovascular Disease |  presence rvd |  artery renal |  systolic blood pressure |  chs participants
KOL Index score: 13032

PURPOSE: This retrospective review describes surgical management of dialysis-dependent ischemic nephropathy.

METHODS: From February 1987 through September 1993, 340 patients underwent operative renal artery (RA) reconstruction at our center. A subgroup of 20 patients (6 women; 14 men; mean age 66 years) dependent on hemodialysis immediately before RA repair form the basis of this report. Glomerular filtration rates (EGFR) were estimated from at least three serum creatinine measurements ...

Also Ranks for: Surgical Management |  ischemic nephropathy |  dialysis patients |  egfr operation |  artery renal
KOL Index score: 12278

PURPOSE: The intimal hyperplasia hypothesis that equates lumen narrowing after arterial injury with intimal mass has recently been challenged. Evidence has emerged to suggest that lumen narrowing is caused in large part by changes in artery wall geometry rather than intimal mass per se. We have begun to explore this hypothesis in a unique nonhuman primate model of atherosclerosis.

METHODS: Monkeys who were fed an atherogenic diet for 3 to 5 years underwent experimental angioplasty of the ...

Also Ranks for: Wound Healing |  arterial reconstruction |  lumen narrowing |  balloon animals |  artery wall
KOL Index score: 11759

PURPOSE: The surgical management of chronic atherosclerotic renal artery occlusion (RA-OCC) was studied.

METHODS: From January 1987 through December 1996, 397 consecutive patients were treated for atherosclerotic renal artery disease. Ninety-five hypertensive patients (mean blood pressure, 204 +/- 31/106 +/- 20 mm Hg; mean medications, 3.0 +/- 1.1 drugs) were treated for 100 RA-OCCs. Eighty-four (88%) patients had renal dysfunction, defined by serum creatinine levels >/=1.3 mg/dL (mean ...

Also Ranks for: Renal Artery |  blood pressure |  vascular humans hypertension |  aged nephrectomy |  surgical management
KOL Index score: 11445

To assess renal duplex sonography as an intraoperative study to detect technical defects during repair, 57 renal artery reconstructions in 35 patients were studied. Sixteen men and 19 women (mean age, 62 years) underwent unilateral (13 patients) or bilateral (22 patients) renal artery repair to 57 kidneys. Methods of repair included aortorenal bypass grafting in 29 cases (20 saphenous vein, 5 polytetrafluoroethylene, 4 Dacron), reimplantation in 7, transrenal thromboendarterectomy with ...

Also Ranks for: Renal Artery |  duplex sonography |  technical defects |  35 patients |  follow studies
KOL Index score: 10846

PURPOSE: This retrospective review describes the surgical management of consecutive patients with severe hypertension and ischemic nephropathy due to atherosclerotic renovascular disease.

METHODS: From January 1987 through December 1998, a total of 590 patients underwent operative renal artery repair at our center. A subgroup of 232 hypertensive patients (97 women, 135 men; mean age, 66 +/- 8 years) with atherosclerotic renovascular disease and preoperative serum creatinine levels of 1.8 ...

Also Ranks for: Ischemic Nephropathy |  renal function |  death dialysis |  patients surgery |  hazard ratio
KOL Index score: 10805

Blood flow and the tractive force shear stress are important determinants of artery caliber, and reduced shear predisposes arteries to intimal thickening and atherosclerosis. The molecular basis for shear-induced changes in artery wall structure is poorly defined. A number of factors associated with normal and pathological artery wall remodeling are induced by shear stress in endothelial cell cultures. These include platelet-derived growth factor (PDGF), a potent mitogen, ...

Also Ranks for: Blood Flow |  growth factor |  receptor expression |  shear stress |  messenger rats
KOL Index score: 10743

This retrospective review of data collected during a recent 42-month period from 58 consecutive patients with ischemic nephropathy submitted to operative management in the authors' center was undertaken to report the rate of decline in their renal function during the period before intervention and to examine the impact of operation on their outcome. Based on serum creatinine values, immediate preoperative estimated glomerular filtration rates (EGFR) ranged from 0 to 46 mL/minute (mean, ...

Also Ranks for: Ischemic Nephropathy |  renal insufficiency |  operation patients |  renovascular kidney failure |  decline egfr
KOL Index score: 10610

With the exception of conventional angiography, no previously proposed screening test has the necessary sensitivity/specificity to guide further evaluation for correctable renovascular disease. Recently, renal duplex sonography has been suggested as a useful substitute in such screening for renovascular disease. This report analyzes our data collected over the past 10 months in evaluation of renal duplex sonography to examine its diagnostic value. The study population for renal duplex ...

Also Ranks for: Renal Duplex Sonography |  renovascular disease |  clinical utility |  conventional angiography |  sensitivity specificity
KOL Index score: 10091

PURPOSE: This retrospective review describes the surgical management of 51 patients after failed percutaneous renal artery angioplasty (F-PTRA).

METHODS: From January 1987 through June 1998, 51 consecutive patients underwent surgical repair of either atherosclerotic (32 patients) or fibromuscular dysplastic (FMD; 19 patients) renovascular vascular disease after F-PTRA. These patients form the basis of this report. Surgical repair was performed for hypertension (29 patients with ...

Also Ranks for: Renal Artery |  patients fmd |  blood pressure |  surgical repair |  patient atherosclerosis
KOL Index score: 10070

OBJECTIVE: This review describes the clinical outcome of surgical intervention for atherosclerotic renovascular disease in 500 consecutive patients with hypertension.

METHODS: From January 1987 to December 1999, 626 patients underwent operative renal artery (RA) repair at our center. A subgroup of 500 patients (254 women and 246 men; mean age, 65 plus minus 9 years) with hypertension (mean blood pressure, 200 plus minus 35/104 plus minus 21 mm Hg) and atherosclerotic RA disease forms the ...

Also Ranks for: Renal Function |  renovascular disease |  blood pressure |  surgical management |  patients hypertension
KOL Index score: 9339

OBJECTIVE: This study evaluated the value of operation for treatment of all octogenarians with ruptured abdominal aortic aneurysms (AAA).

SUMMARY BACKGROUND DATA: Elective AAA resection in octogenarians is safe, with published operative mortality rates of approximately 5%. Published operative mortality rates of ruptured AAA in this age group, however, vary from 27 to 92%.

METHODS: To evaluate this question, we extracted the clinical course of the 34 octogenarians submitted to AAA ...

Also Ranks for: Aortic Aneurysm |  ruptured aaa |  operative mortality |  treatment abdominal |  aged 80
KOL Index score: 9287

BACKGROUND: Angiotensin II may contribute to atherogenesis by facilitating the proliferative and inflammatory response to hypercholesterolemia. This study determined, in a primate model of diet-induced atherosclerosis, the effect of AT(1) blockade on fatty-streak formation, plasma lipids, and surrogate markers of vascular injury.

METHODS AND RESULTS: Male cynomolgus monkeys fed a diet containing 0.067 mg cholesterol/kJ for 20 weeks were given losartan (180 mg/d, n=6) or vehicle (n=8) for ...

Also Ranks for: Treatment Losartan |  serum levels |  angiotensin receptor |  early atherogenesis |  6 weeks
KOL Index score: 8952

To examine the treatment methods and early results of renovascular repair in our contemporary patient population, we reviewed our surgical experience during a recent 54-month period. From January 1987 to July 1991, 200 patients ranging in age from 5 to 80 years (mean, 56 years) were operated on for correction of nonatherosclerotic (43 patients) and atherosclerotic (157 patients) renovascular disease. The group included 92 men and 108 women, with blood pressures ranging from 300/198 mm Hg ...

Also Ranks for: Renovascular Disease |  dialysis operation |  renal insufficiency |  surgical management |  11 patients

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RICHARD H DEAN:Expert Impact

Concepts for whichRICHARD H DEANhas direct influence:Renovascular hypertension,  Renal artery,  Renovascular disease,  Blood pressure,  Surgical management,  Renal function,  Renal duplex sonography,  Operative management.


Concepts related to the work of other authors for whichfor which RICHARD H DEAN has influence:Renal artery,  Renovascular hypertension,  Blood pressure,  Aortic aneurysm,  Fibromuscular dysplasia,  Renin angiotensin,  Ischemic nephropathy.



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Division of Surgical Sciences, Section on Vascular and Endovascular Surgery, Wake Forest University School of Medicine, Winston-Salem, NC | Division of Surgical Sciences, Section on Vascular Surgery and Department of Public Health Sciences, Wake Fore