Research Article| Volume 57, ISSUE 2, P345-352, February 1965

Surgery for renovascular hypertension

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      The development of knowledge about renovascular hypertension has demonstrated that vascular reconstruction of diseased renal arteries can often alter the hypertensive process. Atherosclerosis and fibromuscular hyperplasia are the most common causes of stenotic or occlusive lesions of the renal arteries, but emboli, aneurysms, or trauma may also produce this difficulty. Involvement of the vessels varies from a short segmental narrowing to extensive disease of the artery and its branches. The form of reconstruction utilized must be based on the disease present. The various techniques available are discussed, and the autologous saphenous vein bypass graft and the segmental resection with end-to-end anastomosis are described in detail. The saphenous vein bypass graft is the most versatile and generally applicable technique in use at the present time. Segmental resection with end-to-end anastomosis can be perfomed in many patients with fibromuscular hyperplasia. These two procedures can be satisfactorily utilized for most situations encountered in the surgical treatment of renovascular hypertension.
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