February 1988

Changing Concepts in Surgical Management of Renovascular Hypertension

Author Affiliations

From the Departments of Urology (Drs Libertino, Flam, and Zinman) and Nephrology (Dr Ying) and the Section of Vascular Medicine and Hypertension (Drs Breslin, Swinton, Phelps, Tsapatsaris, and Woods), Lahey Clinic Medical Center, Burlington, Mass. Dr Flam is now with the Clinique Urologique de l'Hôpital Cochin, Paris.

Arch Intern Med. 1988;148(2):357-359. doi:10.1001/archinte.1988.00380020101015

• As newer surgical techniques and concepts have emerged, including revascularization of the totally occluded renal artery and alternatives to aortorenal bypass (hepatic, splenic, or iliac artery to renal artery grafts), our patient population has changed. Patients with diffuse atherosclerotic disease, bilateral renal artery stenosis, totally occluded renal arteries, and azotemia are being referred for renal revascularization, thereby changing the indications for operation and the results that can be anticipated. Although our results in patients operated on solely for uncontrollable hypertension or renal failure have been successful, much work needs to be done to improve the results obtained when patients have a combination of uncontrollable hypertension and renal failure.

(Arch Intern Med 1988;148:357-359)