Surgical treatment of renovascular hypertension | ||||
| Zagazig University Medical Journal | ||||
| Article 476, Volume 26, Issue 4, July 2020, Page 679-689 PDF (959.12 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/zumj.2020.29552.1843 | ||||
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| Authors | ||||
Amr Salem  1; Mohamed Elsayed Salem2; Tarek Mohamed Salem3; Sameh Moustafa4
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| 1Experimental and Clinical Surgery Department , Medical Research Institute , Alexandria University , Alexandria, Egypt | ||||
| 2Vascular Surgery Unit, Department osf Surgery, Faculty of Medicine, Alexandria University, Egypt. | ||||
| 3Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University , Egypt. | ||||
| 4Vascular Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria University , Egypt. | ||||
| Abstract | ||||
| Background: Renovascular hypertension is the commonest form of secondary hypertension. It occurs in less than 5 % of all hypertensive population. There are two forms of renovascular hypertension: Atherosclerotic and fibromuscular dysplasia. The aim was to evaluate the indications of surgical treatment of “renovascular hypertension”. Methods: Twenty cases with renovascular hypertension were included. The main investigations were: Laboratory studies, Duplex ultrasound, Intravenous pyelogram, CT angiography, aortography and selective renal angiography. Indications for surgery were : complex disease of the renal artery, aneurysm, accessory renal arteries, fibromuscular dysplasia and partial damaged of one kidney, atherosclerotic stenosis of the renal arteries and complete kidney damage. Results : The patients were divided into two groups : (Fibromuscular dysplasia group)which included 14 patients, (100.0%) were females, their age ranged from 18 to55 to 68 years with the mean±SD( 62 ±4.1), 5(83.3%)were males and 1(16.7%) was female. Renal artery bypass graft was done for 15 cases, endarterectomy in 2 cases, endarterectomy with patch graft in two cases and nephrectomy in one case. Control of hypertension was successful in 17 cases, partial control of 2 cases, while the blood pressure still high in case of nephrectomy. No mortality in both groups within 6 months follow up period. Conclusions : Surgical treatment for renovascular hypertension is mandatory for complex disease of the renal artery, aneurysms and failure of endovascular procedures. Nephrectomy is the treatment of choice for damaged kidney | ||||
| Keywords | ||||
| Renovascular hypertension; renal artery stenosis; renal artery bypass; renal revascularization. | ||||
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