Bilateral Renal Artery Reconstruction

RECENT reports have indicated that operative treatment of renovascular hypertension in patients over 50 years of age is not warranted because of high morbidity, high mortality, and poor response.1,2This has not been our experience; of 162 patients with renovascular hypertension who underwent operative treatment, 70 were over 50 years of age and 56 (80%) of these were either cured or improved one year later.3The overall operative mortality was 8.6%, but five of the six operative deaths occurred in patients who were simultaneously undergoing operative treatment for abdominal aortic aneurysm or for occlusive disease. Only one death (1.9%) occurred in a patient in whom operative treatment was limited to the renal arteries. We describe a patient with severe renovascular hypertension and bilateral renal artery stenosis who was treated with bilateral aortorenal bypass grafts and who has had a ten-year serial arteriographic follow-up. Report of a Case A