[35 years of experience in reconstructive operations in surgery of vasorenal hypertension]

Reconstructive surgery was performed in 1148 patients with renal hypertension in the period from 1961 to 1996. Extracorporeal microsurgical correction with subsequent kidney autotransplantation was used in case of the lesions of the renal arteries branches. In 161 (14%) of the patients the result was unsatisfactory. The reasons of unsatisfactory results were the following: uncorrected stenosis of the contralateral renal artery (43%), nephrosclerosis of the contralateral kidney (26%), unknown reasons (31%). The long-term results have been followed up in 769 (67%) of the patients in the period for 135 +/- 4 months after the surgery. In 546 (71%) of the patients positive results persisted. The average time of symptomatic recurrence was 74 +/- 6 months after the surgery. Restenosis was the reason of recurrence in 61 (57%) of the patients. Based on these results the following recommendations are postulated: in atherosclerosis--the transaortic endarterectomy from the opening of the renal artery; in fibromuscular displasia--renal artery resection with end-to-end anastomosis; in nonspecific aorcic arteritis--bypass operations.