Mattila T, Harjola P T, Ketonen P, Varstela E, Hekali P
Ann Clin Res. 1985;17(1):19-23.
Fifty consecutive patients with renal artery occlusive disease underwent surgery for renovascular hypertension. The etiology was arteriosclerosis; only three patients had fibromuscular hyperplasia. Isolated renal artery stenosis was operated on in 22 patients while 28 patients underwent combined renal and aortoiliac/femoral procedures. Four of the patients required re-operation because of unsuccessful primary results. There was no operative mortality. Renin was determined in 29 patients and postoperative angiography was carried out in 22 cases. The patency rate of the aorto-renal grafts was 94%; 2 aneurysmal vein graft dilatations occurred. Preoperative renin assays were positive in 90% of the patients with isolated renal artery stenosis but in only 45% of those having renal and aortoiliac/femoral arteriosclerosis. Postoperatively, the renin values had returned to normal limits in 95% of the patients. Long-term (2-11 years) successful treatment of hypertension was achieved in 79% of the cases with isolated stenosis and in 59% of the cases with aorto-iliac/femoral arteriosclerosis. The patients having a preoperative ipsilateral/contralateral renin ratio greater than or equal to 1.5 showed a success rate of 69%. Normal levels of renin were found in 85% of the successful cases.
五十例连续性肾动脉闭塞性疾病患者接受了肾血管性高血压手术治疗。病因是动脉硬化；只有三例患者患有纤维肌增生症。22例患者接受了单纯肾动脉狭窄手术，28例患者接受了肾动脉与腹主动脉-髂动脉/股动脉联合手术。四名患者因初次手术结果不佳而需要再次手术。无手术死亡病例。对29例患者进行了肾素测定，对22例患者进行了术后血管造影。主动脉-肾移植的通畅率为94%；发生了2例静脉移植瘤样扩张。术前肾素测定在90%的单纯肾动脉狭窄患者中呈阳性，但在肾动脉与腹主动脉-髂动脉/股动脉均有动脉硬化的患者中仅45%呈阳性。术后，95%的患者肾素值恢复到正常范围。在单纯狭窄病例中，79%的患者高血压得到长期（2至11年）成功治疗；在腹主动脉-髂动脉/股动脉动脉硬化病例中，59%的患者高血压得到长期成功治疗。术前同侧/对侧肾素比值大于或等于1.5的患者成功率为69%。85%的成功病例肾素水平正常。
