Results of surgery in fibrodysplastic renal artery stenosis

Abstract

patients underwent operations for renovascular hypertension between September, 1971, and August, 1979. In 75 (37.2%) of the patients (64 female and 11 male, ages 8-55 years), a fibrodysplastic stenosis of one or both renal arteries was found. These patients were treated after angiographic demonstration of a renal artery stenosis, with no further functional testing, e.g., renal vein renin ratio or Saralasin test. Operative procedures included resection of the stenosis and reanastomosis in 45, vein patch angioplasty in 13, vein graft reconstruction in 11, and reimplantation of the renal artery into the aorta in 6 patients. In 5 patients (6.7%) a nephrectomy was necessary because of artery thrombosis. There were no operative deaths. Ninety-six percent of the patients showed a normal or improved blood pressure in the immediate postoperative course. In more than 85% of the patients, reinvestigated 2, 4, and 6 years after the operation, hypertension was cured or improved. We conclude that surgical treatment of renal artery stenosis of fibrodysplastic origin is indicated without further functional tests.

Reoperation for complications of renal artery reconstructive surgery undertaken for treatment of renovascular hypertension

“…Included was one death following a secondary operation, resulting in a reoperative mortalig~ rate of 1.4%. Primao~ operations performed in thc authors' total experience included autogcnous saphcnous vein graf~s originating from the aorta or iliac vcsscls (278), similarly placed prosthetic grafts (88), ncphrectomy (27, including 18 tbr advanced parcnchvmal disease), resection and reanastomosis of thc involved vessel or anastomosis of it to an adjacent renal artery (15), local angioplast T (14), endartcrectomy (11), resection and aortic rcimplantation of the renal arteD' (7), dilation (7), autogenous iliac artery aortorenal grafts (5), splcnorenal bypass (1), and renal arteD, exploration without dircct rcconstruction (2). Excluded from this review were reoperations following reconstructive surgery pcrfbrmed for renal arteD, dissections, traumatic rcnal artery lesions, aneuusms unassociated with stenotic disease, and renal arteriovenous fistulas or mallbrmations.…”