Document Type : Original Article
Authors
1
Experimental and Clinical Surgery Department , Medical Research Institute , Alexandria University , Alexandria, Egypt
2
Vascular Surgery Unit, Department osf Surgery, Faculty of Medicine, Alexandria University, Egypt.
3
Endocrinology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University , Egypt.
4
Vascular 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
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