[Multiple renal arteries and renovascular hypertension]

Area of Science:

• Vascular Surgery
• Nephrology
• Hypertension Research

Background:

• Multiple renal arteries (MRA) are a common finding, present in 13% of angiographic examinations.
• While not a direct cause, MRA can be involved in the development of vasorenal hypertension.
• Understanding the role of MRA affection in hypertension is crucial for effective treatment.

Purpose of the Study:

• To analyze the outcomes of treating vasorenal hypertension associated with multiple renal arteries.
• To evaluate the efficacy and safety of reconstructive surgical interventions on affected MRA.
• To determine the optimal surgical approach for patients with MRA-related hypertension.

Main Methods:

• Retrospective analysis of 55 patients diagnosed with vasorenal hypertension involving one or more MRA.
• Surgical interventions focused on restoring blood flow in affected MRA.
• Assessment of treatment success based on blood flow restoration and hypertension reduction.
• Monitoring for complications such as restenosis and thrombosis.

Main Results:

• Surgical interventions successfully restored blood flow in 91.0% of patients.
• A significant reduction in hypertension was achieved in 85.4% of patients post-intervention.
• Complications, including restenosis and thrombosis, occurred in 12.7% of cases.
• One patient experienced fatal acute renal failure due to renal artery thrombosis.

Conclusions:

• Organ-preserving reconstructive operations are highly effective for treating MRA-related vasorenal hypertension.
• Nephrectomy should be reserved for cases of intraorganic renal vessel affection or complete kidney function loss.
• Surgical management of MRA affection offers a successful treatment pathway for vasorenal hypertension.