0
ARTICLE |

Renovascular Hypertension in the Patient With Severe Atherosclerosis FREE

Richard E. Fry, MD; William J. Fry, MD
[+] Author Affiliations

Accepted for publication Aug 27, 1981.

Reprint requests to Department of Surgery, The University of Texas Health Science Center, 5323 Harry Hines Blvd, Dallas, TX 75235 (Dr R. Fry).


Arch Surg. 1982;117(7):938-941. doi:10.1001/archsurg.1982.01380310048011
Text Size: A A A
Published online

• From 1976 to 1981, 22 patients were treated for atheroslcerotic renovascular disease and widespread atherosclerosis. The average age was 56 years. Preoperatively, the average blood pressure (BP) was 211/123 mm Hg. The standard operation was aortorenal bypass, associated with resection of an abdominal aortic aneurysm in three cases. Four patients had nephrectomy. Most patients were referred after failure of a previous renal revascularization procedure. In three patients, most of the renal arterial system was thrombotic. All patients had preoperative Swan-Ganz catheter placement for monitoring of fluid balance, filling pressure, and cardiac output. Intravenous vasodilators were used to control BP and to reduce the afterload on the left ventricle. There were no operative deaths. The average postoperative BP was 136/81 mm Hg. Three patients had improvement in renal function, and one was able to stop hemodialysis after operation. Because of a low mortality and overall satisfactory results, patients with atherosclerotic renovascular hypertension should be considered for vascular reconstruction.

(Arch Surg 1982;117:938-941)

REFERENCES

Ernst CB, Stanley JC, Marshall FF, et al:  Renal revascularization for arteriosclerotic renovascular hypertension: Prognostic implication of focal renal arterial versus overt generalized arteriosclerosis . Surgery 1973;; 73:859-867.
Foster JH, Dean RH, Pinderton JA, et al:  Ten years experience with the surgical management of renovascular hypertension . Ann Surg 1973;;177:755-766.
Foster JH, Maxwell MH, Franklin SS, et al:  Renovascular occlusive disease: Results of operative treatment . JAMA 1975;;231:1043-1048.
Lawrie GM, Morris GC, Soussou ID, et al:  Late results of reconstructive surgery for renovascular disease . Ann Surg 1979;;191:528-533.
Stanley JC, Fry WJ:  Surgical treatment of renovascular hypertension . Arch Surg 1977;;112:1291-1297.
Cohn JN, Franciosa JA:  Vasodilator therapy of cardiac failure (first of two parts) . N Engl J Med 1977;;297:27-32.
Cohn JN, Franciosa JA:  Vasodilator therapy of cardiac failure (second of two parts) . N Engl J Med 1977;;297:254-258.
Dean MT, Lawson JD, Hollifield JW, et al:  Revascularization of the poorly functioning kidney . Surgery 1979;;85:44-52.
Whitehouse WM, Kazmers A, Zelenock GB, et al:  Chronic total renal artery occlusion: Effects of treatment on secondary hypertension and renal function . Surgery 1981;;89:753-763.
Kuhlmann U, Vetta W, Furner J, et al:  Renovascular hypertension: Treatment by percutaneous transmural dilatations . Ann Intern Med 1980;; 92:1-6.
Schwarten DR, Yune HY, Klatte EC, et al:  Clinical experience with percutaneous transmural angioplasty (PTA) of stenotic renal arteries . Radiology 1980;;835:601-604.
Tegtmeyer CJ, Dyer R, Teates CD, et al:  Percutaneous transluminal dilatation of the renal arteries: Techniques and results . Radiology 1980;; 135:589-599.

First Page Preview

First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Ernst CB, Stanley JC, Marshall FF, et al:  Renal revascularization for arteriosclerotic renovascular hypertension: Prognostic implication of focal renal arterial versus overt generalized arteriosclerosis . Surgery 1973;; 73:859-867.
Foster JH, Dean RH, Pinderton JA, et al:  Ten years experience with the surgical management of renovascular hypertension . Ann Surg 1973;;177:755-766.
Foster JH, Maxwell MH, Franklin SS, et al:  Renovascular occlusive disease: Results of operative treatment . JAMA 1975;;231:1043-1048.
Lawrie GM, Morris GC, Soussou ID, et al:  Late results of reconstructive surgery for renovascular disease . Ann Surg 1979;;191:528-533.
Stanley JC, Fry WJ:  Surgical treatment of renovascular hypertension . Arch Surg 1977;;112:1291-1297.
Cohn JN, Franciosa JA:  Vasodilator therapy of cardiac failure (first of two parts) . N Engl J Med 1977;;297:27-32.
Cohn JN, Franciosa JA:  Vasodilator therapy of cardiac failure (second of two parts) . N Engl J Med 1977;;297:254-258.
Dean MT, Lawson JD, Hollifield JW, et al:  Revascularization of the poorly functioning kidney . Surgery 1979;;85:44-52.
Whitehouse WM, Kazmers A, Zelenock GB, et al:  Chronic total renal artery occlusion: Effects of treatment on secondary hypertension and renal function . Surgery 1981;;89:753-763.
Kuhlmann U, Vetta W, Furner J, et al:  Renovascular hypertension: Treatment by percutaneous transmural dilatations . Ann Intern Med 1980;; 92:1-6.
Schwarten DR, Yune HY, Klatte EC, et al:  Clinical experience with percutaneous transmural angioplasty (PTA) of stenotic renal arteries . Radiology 1980;;835:601-604.
Tegtmeyer CJ, Dyer R, Teates CD, et al:  Percutaneous transluminal dilatation of the renal arteries: Techniques and results . Radiology 1980;; 135:589-599.

Correspondence

CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.