Nordhus O, Ekeström S, Liljeqvist L, Tidgren B
Scand J Thorac Cardiovasc Surg. 1978;12(2):111-9. doi: 10.3109/14017437809100359.
Over a period of 8 years, 52 patients (31 females and 21 males) between 12 and 59 years of age (mean age 40 years) underwent renal artery reconstruction for correction of renovascular hypertension. Five patients were operated on bilaterally. A thoracoretroperitoneal approach was chosen at 48 of 57 renal artery reconstructions. The most used types of arterial reconstruction were thrombendarterectomy and vein patch, resection of the stenosis and end-to-end anastomosis, vein patch only or aortorenal vein bypass. No early or late nephrectomies were performed. These was no operative mortality, but 3 late deaths occurred. Twenty-two patients were normotensive postoperatively, 20 were improved and there were 10 failures. The follow-up time as 1--8 years. The blood pressures were measured after withdrawal of antihypertensive drugs for at least 10 days. The best predictable criterion for normotension was a positive renin test with a renin ratio of 1.5 or more. The normotensive patients were in the younger age group with a shorter duration of known hypertension and had mainly fibromuscular hyperplasia.
在8年的时间里，52例年龄在12至59岁（平均年龄40岁）之间的患者（31例女性和21例男性）接受了肾动脉重建术以纠正肾血管性高血压。5例患者接受了双侧手术。在57例肾动脉重建术中，48例采用了胸腹联合后腹膜途径。最常用的动脉重建类型是血栓内膜切除术和静脉补片、狭窄切除术和端端吻合术、仅静脉补片或主动脉肾静脉旁路术。未进行早期或晚期肾切除术。无手术死亡，但发生了3例晚期死亡。22例患者术后血压正常，20例有所改善，10例治疗失败。随访时间为1至8年。在停用抗高血压药物至少10天后测量血压。血压正常的最佳预测标准是肾素试验阳性，肾素比值为1.5或更高。血压正常的患者年龄较轻，已知高血压的病程较短，主要为纤维肌性增生。
