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Long-term Relief of Renovascular Hypertension by In Situ Operative Correction

Isaam D. Soussou, MD; David S. Starr, MD; Gerald M. Lawrie, MD; George C. Morris, Jr, MD

Arch Surg. 1979;114(12):1410-1415.

Abstract
• Renal artery aneurysm is an uncommon cause of renovascular hypertension. Nephrectomy or, more recently, ex vivo arterial reconstruction have been recommended as the treatment of choice. In contrast, we advocate in situ repair of the aneurysm and any associated lesions. Twenty-five hypertensive patients with 30 renal artery aneurysms were treated by tangential aneurysmectomy with primary arteriorrhaphy, saphenous vein patch angioplasty, or bypass graft. Nephrectomy was performed in two patients, one for a ruptured aneurysm. There was no operative mortality. Follow-up was obtained on all patients six months to 19 years after operation. Hypertension was relieved immediately and in the long-term in the majority of survivors. We believe these results indicate that despite the presence of severe renovascular disease, the affected kidney can be preserved and hypertension successfully relieved by a direct surgical approach without recourse to either nephrectomy or ex vivo reconstruction.

(Arch Surg 114:1410-1415, 1979)

Author Affiliations
From the Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston.

Footnotes
Accepted for publication July 18, 1979.

Read before the 27th scientific meeting of the International Cardiovascular Society, June 29, 1979, Nashville, Tenn.

Reprint requests to Department of Surgery, 1200 Moursund, Houston, TX 77030 (Dr Morris).

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