Pinkerton J A, Crouch T T, Sharma J N
Am J Surg. 1979 Dec;138(6):759-63. doi: 10.1016/0002-9610(79)90292-7.
The evaluation of patients with inadequate control of diastolic blood pressure for surgically correctable forms of hypertension led to the detection and surgical treatment of 56 patients. Detection was facilitated by the use of hypertensive intravenous pyelography and Hippuran renal Scanning. Aortography proved the presence of renal artery disease and renal vein renin assay established its significance in the etiology of the patients' hypertension. Renal artery reconstruction was performed in 50 patients, including 5 who also had reconstruction of major aortoiliac lesions. The extent of renal artery disease precluded arterial reconstruction in six patients, who required nephrectomy. Two postoperative deaths occurred, for a mortality rate of 3.6 per cent. Improvement in mean diastolic blood pressure for the total group of patients from 118 mm Hg preoperatively to 86 mm Hg postoperatively was achieved. Forty-six patients (85 per cent) have a diastolic blood pressure of 90 mm Hg or less; in 5 patients the diastolic blood pressure is 91 to 100 mm Hg but is at least 20 mm Hg lower than the preorative level.
对舒张压控制不佳的患者进行评估，以寻找可通过手术矫正的高血压类型，结果发现并手术治疗了56例患者。高血压静脉肾盂造影和马尿酸肾扫描有助于检测。主动脉造影证实存在肾动脉疾病，肾静脉肾素测定确定了其在患者高血压病因中的意义。50例患者进行了肾动脉重建，其中5例还进行了主-髂动脉主要病变的重建。6例患者因肾动脉疾病范围过大无法进行动脉重建，需行肾切除术。术后发生2例死亡，死亡率为3.6%。患者总体平均舒张压从术前的118 mmHg降至术后的86 mmHg。46例患者（85%）舒张压降至90 mmHg或更低；5例患者舒张压为91至100 mmHg，但至少比术前水平低20 mmHg。
