Operative management of renovascular hypertension.

Abstract:

:From 1966 to 1975, 38 patients underwent 42 procedures for renovascular hypertension; 35 operations were aortorenal bypasses and 7 were nephrectomies. Forty-five per cent of the patients were cured, 43% were improved and 12% were unimproved. There were no operative deaths and only three late deaths. Two grafts occluded and 2 became stenotic, giving a graft complication rate of 12%. Curability was best correlated with a short history of hypertension and a pathologic diagnosis of fibromuscular hyperplasia, but not with patient age. Most patients selected for surgery had elevated renal venous renin ratios, and of these 95% were cured or improved. Of those with normal renin ratios, 85% were still cured or improved. Postoperative aortography and peripheral renin measurements offered valuable information in predicting the ultimate response to surgery. Preservation of renal function was a principal indication for surgery in 11 patients. In 8, azotemia was documented preoperatively. Hypertension was cured or improved in every case and 5 patients demonstrated a 10-50% reduction in BUN and creatinine following revascularization.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

McCombs PR,Berkowitz HD,Roberts B

doi

10.1097/00000658-197512000-00019

subject

Has Abstract

pub_date

1975-12-01 00:00:00

pages

762-6

issue

6

eissn

0003-4932

issn

1528-1140

journal_volume

182

pub_type

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