[Surgical intervention in stenoses and aneurysms of the renal artery]

Corrective vascular surgery was performed on 36 patients with renovascular hypertension and one patient with normal tension for 38 defective renal arteries, among them 58 per cent with arteriosclerosis and 35 per cent with fibromuscular dysplasia, in Jena, between 1969 and 1985. Follow-up checks were conducted six years from the operations (average) and revealed three major long-time results: Average blood pressure had declined from 211/121 mm Hg preoperatively to 152/95 mm Hg postoperatively. Renal functions were stabilised. Necessary antihypertensive medication could be reduced to 42 per cent of the preoperative values. Three revascularised kidneys had to be surgically removed in a second session. Four patients had died, the grey figure being one. Restenosation was recorded from three of 28 morphologically assessed arteries. Aneurysmal dilatation of a bridging graft was recorded in one case. Revascularisation proved necessary in another two. The point can be made that in cases of reno-arterial stenosis corrective vascular surgery has continued to be a valid therapeutic concept, adequate indication provided. It still is a real alternative to percutaneous transluminal angioplasty, nephrectomy or isolated therapeutic medication.