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Arterial Reconstructive Surgery for Renovascular Hypertension

Arterial Reconstructive Surgery for Renovascular Hypertension Abstract • Many hypertensive patients with renal artery stenosis and abnormal findings on renin angiotensin assay can be cured or markedly improved by renal artery surgery. Because the mortality is low, we think that patients whose blood pressures are resistant to medical management should be examined carefully for renal artery stenosis as the cause of their hypertension. If such a lesion is found, many of these patients can expect to enjoy a good clinical response from renal artery reconstruction. Those patients who do not have satisfactory results from the surgical correction should undergo aggressive reevaluation to detect any correctable anatomic defects. (Arch Surg 1981;116:999-1002) References 1. Bookstein JJ, Abrams HL, Beunger RE, et al: Radiological aspect of renovascular hypertension: III. Appraisal of arteriography . JAMA 1972;221:368-374.Crossref 2. Breslin DJ, Swinton NW: Renovascular hypertension: Surgical vs medical therapeutic considerations . Med Clin North Am 1979;63:397-400. 3. Hunt JC, Strong CG: Renovascular hypertension: Mechanisms, natural history and treatment . Am J Cardiol 1973;32:562-574.Crossref 4. Hunt JC, Sheps SG, Harrison EG, et al: Renal and renovascular hypertension: A reasoned approach to diagnosis and management . Arch Intern Med 1974;133:988-999.Crossref 5. Shapiro AP, MacDonald RH, Scheib E: Renal arterial stenosis and hypertension: Current criteria for surgery . Am J Cardiol 1976;37:1065.Crossref 6. Chung WB, Solvian AJ: Surgical treatment of renovascular hypertension . Am J Surg 1979;138:143-148.Crossref 7. Lankford NS, Donohue JP, Grim CE, et al: Results of surgical treatment of renovascular hypertension . J Urol 1979;122:439-441. 8. Libertino JA, Zinman L, Breslin DJ, et al: Hepatorenal artery bypass in the management of renovascular hypertension . J Urol 1976;115:369-372. 9. Noble MJ, Novick AC, Straffon RA, et al: Aortorenal reimplantation in treatment of renovascular hypertension . Urology 1979;14:566-569.Crossref 10. Novick AC: Autogenous arterial grafts in the treatment of renal artery stenosis . J Urol 1977;118:919-922. 11. Novick AC, Banowsky LHW, Stewart BH, et al: Splenorenal bypass in the treatment of stenosis of the renal artery . Surg Gynecol Obstet 1977;144:891-898. 12. Pechan BW, Novick AC, Stewart BH, et al: Endarterectomy and patchgraft angioplasty in treatment of atherosclerotic renovascular hypertension . Urology 1979;14:487-491.Crossref 13. Felts SH: Progression of medial fibrodysplasia of the renal artery and the development of renovascular hypertension . Nephron 1979;24:89-90.Crossref 14. Sheps SG, Kincaid OW, Hunt JC: Serial renal function and angiographic observations in idiopathic fibrous and fibromuscular stenosis of the renal arteries . Am J Cardiol 1972;30:55-60.Crossref 15. Wollenweber J, Sheps SG, Davis GD: Clinical course of atherosclerotic renovascular disease . Am J Cardiol 1968;21:60-71.Crossref 16. Youngberg SP: Fibromuscular disease of the renal arteries . Med Clin North Am 1977;61:623-641. 17. Case DB, Wallace JM, Keim HJ, et al: Usefulness and limitations of saralasin, a partial competitive agonist of angiotensin II, for evaluating the renin and sodium factors in hypertensive patients . Am J Med 1976;60:825.Crossref 18. Couch WP, Sullivan J, Crave C: The predictive accuracy of renal vein renin activity in the surgery of renovascular hypertension . Surgery 1976;79:70-76. 19. Juncas LI, Strong CG, Hunt JC: Prediction of results of surgery of renal and renovascular hypertension . Arch Intern Med 1974;134:655-660.Crossref 20. Thomas RD, Ball SG, Lee MR: Failure of saralasin to predict a response to surgery in renovascular hypertension . Lancet 1977;1:724-726.Crossref 21. Tucker RM, Stong SG, Brennan LA, et al: Renovascular hypertension: Relationship of surgical curability to renin angiotensin activity . Mayo Clin Proc 1978;53:573-577. 22. Elkestronn S, Liljequiste L, Nordhus O, et al: Persisting hypertension after renal artery reconstruction: A follow up study . Scand J Urol Nephrol 1979;13:83-88.Crossref 23. Stanley JC, Ernst CB, Fry WJ: Fate of 100 aortorenal vein grafts: Characteristics of late graft expansion, aneurysmal dilatation and stenosis . Surgery 1973;74:931. 24. Fry WJ: Renal artery reconstruction . Surg Clin North Am 1979;59:550-563. 25. Dean RH, Lawson JD, Hollifield JW, et al: Revascularization of the poorly functioning kidney . Surgery 1979;85:44-52. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Arterial Reconstructive Surgery for Renovascular Hypertension

Archives of Surgery , Volume 116 (8) – Aug 1, 1981

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Publisher
American Medical Association
Copyright
Copyright © 1981 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1981.01380200015002
Publisher site
See Article on Publisher Site

Abstract

Abstract • Many hypertensive patients with renal artery stenosis and abnormal findings on renin angiotensin assay can be cured or markedly improved by renal artery surgery. Because the mortality is low, we think that patients whose blood pressures are resistant to medical management should be examined carefully for renal artery stenosis as the cause of their hypertension. If such a lesion is found, many of these patients can expect to enjoy a good clinical response from renal artery reconstruction. Those patients who do not have satisfactory results from the surgical correction should undergo aggressive reevaluation to detect any correctable anatomic defects. (Arch Surg 1981;116:999-1002) References 1. Bookstein JJ, Abrams HL, Beunger RE, et al: Radiological aspect of renovascular hypertension: III. Appraisal of arteriography . JAMA 1972;221:368-374.Crossref 2. Breslin DJ, Swinton NW: Renovascular hypertension: Surgical vs medical therapeutic considerations . Med Clin North Am 1979;63:397-400. 3. Hunt JC, Strong CG: Renovascular hypertension: Mechanisms, natural history and treatment . Am J Cardiol 1973;32:562-574.Crossref 4. Hunt JC, Sheps SG, Harrison EG, et al: Renal and renovascular hypertension: A reasoned approach to diagnosis and management . Arch Intern Med 1974;133:988-999.Crossref 5. Shapiro AP, MacDonald RH, Scheib E: Renal arterial stenosis and hypertension: Current criteria for surgery . Am J Cardiol 1976;37:1065.Crossref 6. Chung WB, Solvian AJ: Surgical treatment of renovascular hypertension . Am J Surg 1979;138:143-148.Crossref 7. Lankford NS, Donohue JP, Grim CE, et al: Results of surgical treatment of renovascular hypertension . J Urol 1979;122:439-441. 8. Libertino JA, Zinman L, Breslin DJ, et al: Hepatorenal artery bypass in the management of renovascular hypertension . J Urol 1976;115:369-372. 9. Noble MJ, Novick AC, Straffon RA, et al: Aortorenal reimplantation in treatment of renovascular hypertension . Urology 1979;14:566-569.Crossref 10. Novick AC: Autogenous arterial grafts in the treatment of renal artery stenosis . J Urol 1977;118:919-922. 11. Novick AC, Banowsky LHW, Stewart BH, et al: Splenorenal bypass in the treatment of stenosis of the renal artery . Surg Gynecol Obstet 1977;144:891-898. 12. Pechan BW, Novick AC, Stewart BH, et al: Endarterectomy and patchgraft angioplasty in treatment of atherosclerotic renovascular hypertension . Urology 1979;14:487-491.Crossref 13. Felts SH: Progression of medial fibrodysplasia of the renal artery and the development of renovascular hypertension . Nephron 1979;24:89-90.Crossref 14. Sheps SG, Kincaid OW, Hunt JC: Serial renal function and angiographic observations in idiopathic fibrous and fibromuscular stenosis of the renal arteries . Am J Cardiol 1972;30:55-60.Crossref 15. Wollenweber J, Sheps SG, Davis GD: Clinical course of atherosclerotic renovascular disease . Am J Cardiol 1968;21:60-71.Crossref 16. Youngberg SP: Fibromuscular disease of the renal arteries . Med Clin North Am 1977;61:623-641. 17. Case DB, Wallace JM, Keim HJ, et al: Usefulness and limitations of saralasin, a partial competitive agonist of angiotensin II, for evaluating the renin and sodium factors in hypertensive patients . Am J Med 1976;60:825.Crossref 18. Couch WP, Sullivan J, Crave C: The predictive accuracy of renal vein renin activity in the surgery of renovascular hypertension . Surgery 1976;79:70-76. 19. Juncas LI, Strong CG, Hunt JC: Prediction of results of surgery of renal and renovascular hypertension . Arch Intern Med 1974;134:655-660.Crossref 20. Thomas RD, Ball SG, Lee MR: Failure of saralasin to predict a response to surgery in renovascular hypertension . Lancet 1977;1:724-726.Crossref 21. Tucker RM, Stong SG, Brennan LA, et al: Renovascular hypertension: Relationship of surgical curability to renin angiotensin activity . Mayo Clin Proc 1978;53:573-577. 22. Elkestronn S, Liljequiste L, Nordhus O, et al: Persisting hypertension after renal artery reconstruction: A follow up study . Scand J Urol Nephrol 1979;13:83-88.Crossref 23. Stanley JC, Ernst CB, Fry WJ: Fate of 100 aortorenal vein grafts: Characteristics of late graft expansion, aneurysmal dilatation and stenosis . Surgery 1973;74:931. 24. Fry WJ: Renal artery reconstruction . Surg Clin North Am 1979;59:550-563. 25. Dean RH, Lawson JD, Hollifield JW, et al: Revascularization of the poorly functioning kidney . Surgery 1979;85:44-52.

Journal

Archives of SurgeryAmerican Medical Association

Published: Aug 1, 1981

References