Results following surgical correction of renovascular hypertension

During a 12 year period, 110 patients were submitted to surgery for correction of renovascular hypertension. The pathologic process was atherosclerosis in 65, fibrodysplasia in 28, aneurysms in 6 abdominal coarctation in 5, aortoarteritis in 2 and 3 miscellaneous lesions. Operative procedures used on 148 renal arteries have been: nephrectomy (12), reconstructive surgery (133). Among them: endarterectomy (89), aorto-renal grafts (20) venous, dacron or arterial autografts, resection and anastomosis (10), direct reimplantation (8), angioplasty (5), arterial spleno-renal anastomosis (1). Postoperative arteriograms have been obtained in 98% of the patients, 4 occlusions occurred in aorto renal grafts, no thrombosis in endarterectomy. Progression of dysplasia and atherosclerosis was observed in 5 patients. The overall clinical results show: cure 55%, improvement 34% and no change 11%. With a difference between atherosclerosis (45% cured, 40% improved, 15% no change) and fibrodysplasia (63% cured, 29% improved and 8% no change). Several parameters are studied correlated with the surgical result. This series support interest to treat operatively renovascular hypertension: 89% of patients benefited from surgery.