Operative techniques in renovascular hypertension

The operative technique used for correction of renovascular hypertension is described, basing on the experience with 73 patients operated upon during a 12-year period. Eight nephrectomies were performed, mostly because of irreversible glomerular and tubular atrophy. For arterial repair, three different procedures only were applied. The procedure of choice for most patients was widening of the artery by venous patch grafting, in case of arteriosclerosis combined with endarterectomy. In 7 cases the artery was transected and reimplanted into the infrarenal aorta. In 10 patients extracorporeal repair with replacement of the artery by a venous graft and replantation was performed. There was no operative or postoperative mortality in this series. The hypertension was cured or markedly improved in 96% of the patients with fibromuscular dysplasia, and in 88% of arteriosclerotic cases.