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Reconstruction for renal artery aneurysm and its effect on hypertension
L Reiher1, K Grabitz, W Sandmann
1Department of Vascular Surgery and Renal Transplantation, Heinrich Heine University, Düsseldorf, Germany.
Objectives:
many renal artery aneurysms (RAA) are diagnosed incidentally in the course of investigations for hypertension and their management is controversial.
Aim:
to review the results of renal artery reconstruction for RAA.
Methods:
between January 1978 and December 1998 111 RAR were performed in 81 kidneys in 71 patients.
Results:
fifty-nine patients were hypertensive, three had a creatinine >2.0 mg/dl and one was on dialysis. The principal underlying pathology was fibromuscular dysplasia (39) and atherosclerosis (17). The mean RAA diameter was 2.2 (range 1-15) cm overall and 3.5 (range 2-10) cm in four patients who presented with rupture. Fifty-one patients had renal artery stenosis. Autogenous material was used in 105 RAR. There was no 30-day mortality and the morbidity rate was 16%. The 5-year cumulative patency rate was 69%. Hypertension was cured in 25% and improved in 39%.
Conclusions:
RAR tested for RAA treats hypertension and reduces the risk of rupture and distal embolisation.