[Indications, surgical technique and results in renovascular hypertension (author's transl)]

After more than 25 years of surgical treatment of renovascular hypertension alterations in indication and operative methods have evolved. While split renal function tests have been abandoned, renin values seem of some importance, but the most valuable signs are poststenotic dilatation and collateralisation on the aortogram. For therapy the transcutaneous intraluminal dilatation has been developed as a fairly safe method. Though long term results are lacking this procedure seems indicated under certain conditions. The only primary indication for surgery therefore would be total occlusion of the renal artery. In many instances secondary surgery is still necessary. Interposition of a venous graft is the most often used procedure. In our own experience direct thrombendarterectomy also gives good results. In fibrodysplastic stenoses the results with respect not only to blood pressure behaviour and mortality rate but also life expectancy are satisfactory. On the other hand operations of arteriosclerotic lesions have still a considerable early and late mortality rate. The extent of the underlying disease, age and sex are important factors. The aim of preserving renal function in special situations (occlusion of renal artery, stenosis of single kidney and bilateral stenosis) is especially stressed.