Kotchen T A, Ernst C B
Geriatrics. 1976 Aug;31(8):83-9.
Renovascular hypertension is the most prevalent form of surgically remediable hypertension. With appropriate selection of operative candidates, a high rate of cure or improvement may be anticipated. Favorable results justify revascularization in hypertensive patients with focal arteriosclerotic renal artery disease. The absence of advanced arteriosclerosis provides the most valid basis for predicting long-term survival following revascularization. Patients with clinically demonstrable diffuse arteriosclerotic disease are preferably treated medically; we consider them candidates for surgery only if drug therapy cannot control blood pressure. Renal revascularization does not appear to alter the inexorable progression of concomitant generalized arteriosclerosis. Revascularization rather than nephrectomy is the primary surgical therapy for renal artery stenosis in properly selected patients.
肾血管性高血压是外科可治愈性高血压最常见的形式。通过适当选择手术患者，有望获得较高的治愈率或改善率。对于患有局灶性动脉硬化性肾动脉疾病的高血压患者，良好的治疗效果证明血管重建术是合理的。没有晚期动脉硬化是预测血管重建术后长期生存的最有效依据。临床上可证实患有弥漫性动脉硬化疾病的患者最好采用药物治疗；只有当药物治疗无法控制血压时，我们才将他们视为手术候选者。肾血管重建术似乎不会改变伴随的全身性动脉硬化的不可阻挡的进展。对于经过适当选择的患者，血管重建术而非肾切除术是肾动脉狭窄的主要外科治疗方法。
