Role of intraoperative manometry in renal artery compression by a pheochromocytoma

A case of renal artery stenosis due to compression by a neurofibrous cord (histologically a pheochromocytoma) and resolved by the débridment of the vessel and angioplasty with a patch in the saphenous vein, is reported. After the compression has been relieved, the vessel appeared normal at inspection and palpation (pulsation); the manometric control, recorded distally and proximally to the area of compression by the pheochromocytoma showed a significant gradient of pressure that led to the exploration of the vessel, partially obstructed by a recent thrombus. These lesions were not detectable solely on inspection and palpation. It is stressed that a restored normal aspect after removal of the extrinsic pressure on the renal artery may not represent an equivalent optimal restoration of function. Only manometric control or rate of flow measurements are able to assess the efficacy of surgical reconstruction.