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McCombs PR, Berkowitz HD, Roberts B. Operative management of renovascular hypertension. Ann Surg. 1975;182(6):762-6doi: 10.1097/00000658-197512000-00019.
McCombs, P. R., Berkowitz, H. D., & Roberts, B. (1975). Operative management of renovascular hypertension. Annals of surgery, 182(6), 762-6. https://doi.org/10.1097/00000658-197512000-00019
McCombs, P R, et al. "Operative management of renovascular hypertension." Annals of surgery vol. 182,6 (1975): 762-6. doi: https://doi.org/10.1097/00000658-197512000-00019
McCombs PR, Berkowitz HD, Roberts B. Operative management of renovascular hypertension. Ann Surg. 1975 Dec;182(6):762-6. doi: 10.1097/00000658-197512000-00019. PMID: 1190880; PMCID: PMC1343976.
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Wolters Kluwer Free PMC Article

Ann Surg. 1975 Dec;182(6):762-6. doi: 10.1097/00000658-197512000-00019.

Operative management of renovascular hypertension.

Annals of surgery

P R McCombs, H D Berkowitz, B Roberts

PMID: 1190880 PMCID: PMC1343976 DOI: 10.1097/00000658-197512000-00019
Free PMC Article

Abstract

From 1966 to 1975, 38 patients underwent 42 procedures for renovascular hypertension; 35 operations were aortorenal bypasses and 7 were nephrectomies. Forty-five per cent of the patients were cured, 43% were improved and 12% were unimproved. There were no operative deaths and only three late deaths. Two grafts occluded and 2 became stenotic, giving a graft complication rate of 12%. Curability was best correlated with a short history of hypertension and a pathologic diagnosis of fibromuscular hyperplasia, but not with patient age. Most patients selected for surgery had elevated renal venous renin ratios, and of these 95% were cured or improved. Of those with normal renin ratios, 85% were still cured or improved. Postoperative aortography and peripheral renin measurements offered valuable information in predicting the ultimate response to surgery. Preservation of renal function was a principal indication for surgery in 11 patients. In 8, azotemia was documented preoperatively. Hypertension was cured or improved in every case and 5 patients demonstrated a 10-50% reduction in BUN and creatinine following revascularization.

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