Renal Artery Stenosis and Hypertension: 1. Surgical Treatment

Abstract

Seventy-four patients were operated on for renal artery stenosis or occlusion. Various types of reconstructive procedures were performed or attempted in fifty-five patients. Eight patients died postoperatively. In six of these, atheromatosis was responsible for the stenosis and in three a state of uremia or suburemia was present. The results of operative attempts to treat uremia in cases of renal artery stenosis were discouraging. This may be due to a co-existent parenchymatous damage of the kidneys. During the 1/2–10 years of follow-up, ten patients died. These patients all had atheromatous lesions at their primary operation, and the cause of death was, in all cases except one, related to vascular lesions of various kind. The results with regard to blood pressure were normotension in 38% improvement in 26% no change in 23% and is unknown in 13%. There was no significant difference in blood pressure results between the patients subjected to reconstruction and those subjected to nephrectomy.