J.Jpn. Surg. Soc.. 80(11): 1099-1102, 1979

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Report on the annual meeting

SURGICAL TREATMENT FOR RENOVASCULAR HYPERTENSION WITH PARTICULAR REFERENCE TO ATHEROSCLEROSIS IN ORIGIN

Reconstructive procedure was done for 26 cases with renovascular hypertension, consisting of atherosclerosis in 12, fibromuscular dysplasia in 7, renal artery aneurysm in 3, aortitis syndrome in 2, coarctation of the abdominal aorta in 1 and renal arteriovenous fistula in 1. Particularly renovascular hypertension caused by atherosclerosis is often difficult to treat in terms of postoperative lowering of blood pressure and preoperative assessment of effectiveness of reconstruction to be performed.
In order to bring into light these problems, comparative analysis has been done between atherosclerosis and fibromuscular dysplasia. Seventy % efficacy of the procedure was documented for atherosclerosis, whereas 83.3% was obtained for fibromuscular dysplasia. The only one individual with the latter failed to respond, in whom nephrectomy was done with resultant decrease of blood pressure. Simultaneous bilateral renal artery reconstruction was carried out for 3 cases with atherosclerosis. There were 3 cases with associated aneurysm of the abdominal aorta, which were surgically treated as well. There were 2 hospital deaths (intestinal necrosis and renal failure) and 2 late deaths (rupture of aortic aneurysm and cancer of the stomach), all of whom were found to be in the group of atherosclerosis.

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