This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (57)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Calvin B. Ernst, MD; Joseph J. Bookstein, MD; James Montie, MD; Earl Baumgartel, MD; Sibley W. Hoobler, MD; William J. Fry, MD

AMA Arch Surg. 1972;104(4):496-502.

Abstract
Of 37 patients who underwent successful renal revascularization for unilateral renovascular hypertension, 27 were cured and ten improved. The two most reliable selective criteria for operation were a renin ratio of 1.40 or greater and arteriographic demonstration of collateral channels circumventing the stenotic lesion. Twenty-five patients (68%) had collateral vessels documented arteriographically; 12 did not. Patients lacking collaterals had renin ratios of at least 1.4 with a mean ratio of 2.5. Individuals with collaterals had a mean ratio of 1.8. This suggests that as collaterals develop, ratios revert toward unity. Thirty patients had ratios of 1.4 or greater. Collaterals, indicating a hemodynamically significant lesion, were demonstrated in all seven patients who had ratios under 1.4. These seven patients would have been denied surgical benefit had renin ratios been the only selective criteria.

Author Affiliations
Ann Arbor, Mich

From the departments of surgery (Section of General Surgery) (Drs. Ernst, Montie, Baumgartel, and Fry), medicine (Hypertension Unit) (Dr. Hoobler), and radiology (Dr. Bookstein), University of Michigan Medical Center, Ann Arbor.

Footnotes
Accepted for publication Dec 7, 1971.

Read before the 79th annual meeting of the Western Surgical Association, Portland, Ore, Nov 19, 1971.

Reprint requests to Department of Surgery, University Hospital, Ann Arbor, Mich 48104 (Dr. Ernst).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Peripheral and Renal Vein Renin Activity in Patients with Renovascular Hypertension Due to Nonspecific Aortoarteritis
Lall et al.
ANGIOLOGY 1991;42:979-984.
ABSTRACT  

Simultaneous Aortic and Renal Artery Reconstruction
Shahian et al.
Arch Surg 1980;115:1491-1497.
ABSTRACT  

Clinical Significance of Collateral Circulation to the Ischemic Kidney
Adar et al.
VASC ENDOVASCULAR SURG 1978;12:59-62.
 

Predictability of Surgical Response in Renovascular Hypertension
Buda et al.
Arch Surg 1976;111:1243-1248.
ABSTRACT  

Renovascular Hypertension Secondary to Arterial Fibrodysplasia in Adults: Criteria for Operation and Results of Surgical Therapy
Stanley and Fry
Arch Surg 1975;110:922-928.
ABSTRACT  

Renovascular Hypertension in the Pediatric Patient
Fry et al.
Arch Surg 1973;107:692-698.
ABSTRACT  

Autogenous Saphenous Vein Aortorenal Grafts: A Ten-Year Experience
Ernst et al.
Arch Surg 1972;105:855-864.
ABSTRACT