[Pathophysiology and methods of treatment in renal hypertension in renal artery aneurysms]

Aneurysms of the renal artery occur infrequently and remain mostly asymptomatic. A review of the pertinant literature reveals approximately 300 reports. Hypertension is the predominant sign and affects two thirds of all patients, particularly in aneurysms complicated by stenosis or thromboembolism of renal artery, which is caused by the renin-angiotensin-mechanism. A solitary renal aneurysm causes no renal hypertension; 66% of all diagnosed renal artery aneurysms require no treatment. Resection of the aneurysm and direct suture was done in half of all operated patients. Only in 27 cases operative treatment consisted of extirpation and patch-plastic (autologic or alloplastic). Two additional cases in our own hospital with resection and patch-plastic are described. By using those techniques it is possible to normalize renal artery blood flow as well as blood pressure. Other well-known surgical procedures are nephrectomy, aorto-renalbypass and several others.