In summary, renovascular surgery has evolved during the past 20 years to become a highly efficacious therapeutic modality provided proper patient selection is practiced. Surgical techniques are now well established, and with the advent of ex vivo techniques practically any extraparenchymal renal artery lesion may be repaired. At present, much investigative work is in progress in an attempt to develop better means of selecting patients who will benefit from renovascular surgery. The newer modifications of renal vein renin assays may permit better patient selection. Many factors must be weighted when considering medical versus surgical management of hypertension. Paramount among these must be the quality of life of the patient. The inconstancy of pressure control and the frequency of undesirable side effects in the more extreme medical regimens are the primary disadvantages of nonsurgial management. An aggressive surgical approach appears to be warranted in selected patients with atherosclerosis and in almost all patients with fibromuscular dysplasia.
总之，在过去20年中，肾血管手术已发展成为一种高效的治疗方式，前提是要对患者进行恰当的选择。目前手术技术已成熟，随着体外技术的出现，几乎任何肾实质外肾动脉病变都可以修复。目前，正在进行大量研究工作，试图开发出更好的方法来选择能从肾血管手术中获益的患者。肾静脉肾素测定法的新改进可能有助于更好地选择患者。在考虑高血压的药物治疗与手术治疗时，必须权衡许多因素。其中最重要的必须是患者的生活质量。在更为极端的药物治疗方案中，血压控制的不稳定性和不良副作用的频繁发生是非手术治疗的主要缺点。对于选定的动脉粥样硬化患者和几乎所有纤维肌发育异常患者，积极的手术方法似乎是必要的。
