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THE SURGICAL TREATMENT OF RENOVASCULAR HYPERTENSION: 1. SELECTION AND TECHNIQUES
Author(s) -
Myers Kenneth,
Johnson Neil
Publication year - 1971
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1971.tb88130.x
Subject(s) - medicine , arteriotomy , renovascular hypertension , nephrectomy , renal artery stenosis , renal artery , renal function , stenosis , kidney , renal artery obstruction , surgery , endarterectomy , cardiology , artery
The indications for surgical treatment of 41 patients with renal hypertension are reported. Severe hypertension inadequately controlled by medical treatment was the most common indication; surgery was also recommended if there was associated impaired renal function or malignant hypertension, stenosis of the artery to a single kidney or renal hypertension in a young patient. Arterial reconstruction was performed when possible, the preferred technique being by direct arteriotomy, combined with endarterectomy if required, and widening of the vessel with an autogenous arterial patch. Nephrectomy was required if there was extensive damage to the kidney. Nephrectomy was contraindicated for almost two‐thirds of the patients treated by arterial reconstruction by virtue of the presence of impaired renal function, bilateral renal artery stenosis or stenosis of the artery to a single kidney.