Reconstructive vascular surgery for hypertension in renal vascular dysplasia

28 patients with renovascular hypertension caused by fibromuscular dysplasia involving one or more renal arteries underwent reconstructive surgery. The renal artery stenosis was bilateral in 5 patients. Total artery occlusion occurred in 3 cases. Arteriography was the most useful diagnostic procedure. The operative technique of choice was replacement using saphenous vein or hypogastric artery. All patients survived. On follow-up, 27 patients (96.4%) were either cured or improved. Isotope nephrography suggested restenosis in 1 case. Our results support an aggressive approach to the diagnosis and surgical treatment of renal artery fibromuscular dysplasia causing hypertension.