Renovascular hypertension: surgical treatment.

Renovascular occlusive disease is a common form of surgically remediable secondary hypertension. Operative options include: Bypass grafts, ex vivo reconstructions, endarterectomy, and transluminal dilation. Primary nephrectomy is undertaken only for irreparably diseased ischemic kidneys. Excellent results of surgical treatment reflect accurate identification of operative candidates and performance of appropriate operative procedures. Surgical benefits are more likely in pediatric patients and adults with fibrodysplastic or focal arteriosclerotic renovascular disease than in patients with clinically overt generalized arteriosclerosis. A review of 1631 renovascular hypertensive patients treated operatively documented a salutary outcome in 85-90% of patients.