THERE IS a widely held belief that sudden occlusion of a main renal vein invariably results in renal infarction and loss of the kidney. However, because of a rich collateral circulation, the left kidney may continue to function after renal vein ligation. This was first pointed out by Erlik et al1,2 and has been borne out by a patient recently studied by us. A review of the anatomy of the inferior vena cava and the renal veins as well as a review of the literature has shown that, under certain circumstances, renal survival can be expected after left main renal vein ligation.
Report of a Case
The patient (MSH-266140), a 49-year-old white man, was admitted to the Mount Sinai Hospital on Nov 26, 1964, with severe, sustained hypertension of four months' duration. His blood pressure was approximately 250/140 mm Hg and it was poorly controlled with antihypertensive medications. In