Revascularization of kidneys with totally occluded renal arteries

Nephrectomy has been the accepted treatment for renovascular hypertension due to an occluded renal artery but successful revascularization of occluded renal arteries has resulted in partial return of function and relief of hypertension. We performed aorticorenal bypass operations on four patients whose renal arteries were not patent. One graft failed immediately, two remained open for four to six months, and one is functioning at two years. In 70 other cases in which totally occluded arteries were revascularized, the overall patency rate was 96%. Hypertension was relieved for controlled in 77%.