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Intraoperative Hemodynamics of Renovascular Hypertension

Intraoperative Hemodynamics of Renovascular Hypertension Abstract DESPITE the improvement in recent years of methods for selection of hypertensive patients for renovascular surgery, and despite the overall favorable results of surgery, there remains an element of uncertainty in the prognosis for the individual patient. Various criteria which indicate a favorable prognosis have been suggested such as the degree of abnormality of split renal function tests, the characteristics of the radioactive renogram, the angiographic appearance of the stenosis or the intrarenal vessels, and recently renal vein renin assay levels. None of these to date are truly reliable indicators of the likely outcome, assuming a good technical result of renovascular reconstruction, and all too often the surgeon must operate and hope for the best. The prognosis for the individual patient hinges on three factors: a surgically accessible renal artery lesion which is hemodynamically significant, its successful correction, and whether the kidney beyond, if it is the source of increased References 1. Green, H.D., et al: Blood Flow, Peripheral Resistance and Vascular Tonus , Amer J Physiol 141:518-532 ( (June) ) 1944. 2. Hunt, L.D., et al: Electromagnetic Flowmeter Studies of Human Renal Arterial Blood Flow , J Urol 92:399-408 ( (Nov) ) 1964. 3. Delin, N.A.; Ekestrom, S.; and Höglund, N.O.: Arteriographic Appearance of Renal Artery Stenosis Compared to Resistance Measured at Operation , Acta Chir Scand , supp 356, pp 150-162 ( (Oct 25) ) 1966. 4. Von Ruden, W.J., et al: Multiple Arterial Stenoses: Effect on Blood Flow , Arch Surg 89:307-315 ( (Aug) ) 1964.Crossref 5. Weale, F.E.: The Values of Series and Parallel Resistances in Steady Blood Flow , Brit J Surg 51:623-627 ( (Aug) ) 1964.Crossref 6. Lupu, A.N.; Kaufman, J.J.; and Maxwell, M.H.: Renal Artery Constriction: Physiological Determinants of Pressure Gradients , Ann Surg 167:246-250 ( (Feb) ) 1968.Crossref 7. Morris, G.C., et al: Renal Revascularization for Hypertension , Surgery 48:95-102 ( (July) ) 1960. 8. Kaufman, J.J., and Maxwell, M.H.: Surgery for Renovascular Hypertension , JAMA 190:709-714 ( (Nov) ) 1964.Crossref 9. Spencer, F.C., et al: Diagnosis and Treatment of Hypertension Due to Occlusive Disease of the Renal Artery , Ann Surg 153:674-695 ( (Oct) ) 1961.Crossref 10. Bernatz, P.E.; Hunt, J.C.; and Harrison, E.G.: Idiopathic Fibrous and Fibromuscular Stenoses of the Renal Artery , Arch Surg 85:608-616 ( (Oct) ) 1962.Crossref 11. Stewart, R.H., et al: Renal Hypertension , Arch Surg 85:617-636 ( (Oct) ) 1962.Crossref 12. Waugh, W.H., and Shanks, R.G.: Cause of Genuine Autoregulation of the Renal Circulation , Circ Res 8:871-888 ( (July) ) 1960.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Intraoperative Hemodynamics of Renovascular Hypertension

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Publisher
American Medical Association
Copyright
Copyright © 1968 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1968.01340060102011
Publisher site
See Article on Publisher Site

Abstract

Abstract DESPITE the improvement in recent years of methods for selection of hypertensive patients for renovascular surgery, and despite the overall favorable results of surgery, there remains an element of uncertainty in the prognosis for the individual patient. Various criteria which indicate a favorable prognosis have been suggested such as the degree of abnormality of split renal function tests, the characteristics of the radioactive renogram, the angiographic appearance of the stenosis or the intrarenal vessels, and recently renal vein renin assay levels. None of these to date are truly reliable indicators of the likely outcome, assuming a good technical result of renovascular reconstruction, and all too often the surgeon must operate and hope for the best. The prognosis for the individual patient hinges on three factors: a surgically accessible renal artery lesion which is hemodynamically significant, its successful correction, and whether the kidney beyond, if it is the source of increased References 1. Green, H.D., et al: Blood Flow, Peripheral Resistance and Vascular Tonus , Amer J Physiol 141:518-532 ( (June) ) 1944. 2. Hunt, L.D., et al: Electromagnetic Flowmeter Studies of Human Renal Arterial Blood Flow , J Urol 92:399-408 ( (Nov) ) 1964. 3. Delin, N.A.; Ekestrom, S.; and Höglund, N.O.: Arteriographic Appearance of Renal Artery Stenosis Compared to Resistance Measured at Operation , Acta Chir Scand , supp 356, pp 150-162 ( (Oct 25) ) 1966. 4. Von Ruden, W.J., et al: Multiple Arterial Stenoses: Effect on Blood Flow , Arch Surg 89:307-315 ( (Aug) ) 1964.Crossref 5. Weale, F.E.: The Values of Series and Parallel Resistances in Steady Blood Flow , Brit J Surg 51:623-627 ( (Aug) ) 1964.Crossref 6. Lupu, A.N.; Kaufman, J.J.; and Maxwell, M.H.: Renal Artery Constriction: Physiological Determinants of Pressure Gradients , Ann Surg 167:246-250 ( (Feb) ) 1968.Crossref 7. Morris, G.C., et al: Renal Revascularization for Hypertension , Surgery 48:95-102 ( (July) ) 1960. 8. Kaufman, J.J., and Maxwell, M.H.: Surgery for Renovascular Hypertension , JAMA 190:709-714 ( (Nov) ) 1964.Crossref 9. Spencer, F.C., et al: Diagnosis and Treatment of Hypertension Due to Occlusive Disease of the Renal Artery , Ann Surg 153:674-695 ( (Oct) ) 1961.Crossref 10. Bernatz, P.E.; Hunt, J.C.; and Harrison, E.G.: Idiopathic Fibrous and Fibromuscular Stenoses of the Renal Artery , Arch Surg 85:608-616 ( (Oct) ) 1962.Crossref 11. Stewart, R.H., et al: Renal Hypertension , Arch Surg 85:617-636 ( (Oct) ) 1962.Crossref 12. Waugh, W.H., and Shanks, R.G.: Cause of Genuine Autoregulation of the Renal Circulation , Circ Res 8:871-888 ( (July) ) 1960.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Dec 1, 1968

References