Long-Term Outcome After Surgical Kidney Revascularization for Fibromuscular Dysplasia and Atherosclerotic Renal Artery Stenosis

Abstract

Surgical kidney revascularization is effective in secondary hypertension with a high long-term efficacy in the normalization of blood pressure and in the preservation of renal function, especially in patients with a solitary or 1 functional kidney.

Fibromuscular dysplasia

“…In contemporary surgical series, technical success rates are greater than 88%, long-term blood pressure was either cured or improved in 67% to 93%, and improvement or stabilization of renal function was seen in up to 92% of patients [60,61]. Cure rates in the more recent surgical series are lower than the rates reported in earlier series [62].…”

Early atherosclerosis aggravates the effect of renal artery stenosis on the swine kidney

“…Therefore, therapeutic strategies have focused on restoring renal blood supply. However, improvement in blood pressure control or recovery of renal function after renal revascularization are achieved only in selected ARAS patients (22,23), whereas repair of renal arterial lesions uncomplicated by atherosclerosis often achieves better outcomes (14). These observations suggest that deleterious factors beyond the stenosis, probably triggered by the atherogenic process, play dominant roles in compromising the function and recovery of the ischemic kidney in ARAS.…”

Revascularisation of renal artery stenosis caused by fibromuscular dysplasia: effects on blood pressure during 7-year follow-up are influenced by duration of hypertension and branch artery stenosis

“…1 Previous retrospective studies of materials with only FMD as cause of renal artery stenosis have followed patients for a maximum of 48 months, 1,7 however, whereas follow-up of mean 11.3 years has recently been reported in a mixed material of patients with renal artery stenosis due to either atherosclerosis or fibromuscular dysplasia. 8 Our institution has the responsibility for the treatment of renovascular hypertension in the southernmost health region of Sweden (1.6 million inhabitants), and we now aim to analyse retrospectively long-time effects upon blood pressure (BP), renal function, and antihypertensive treatment in consecutive patients undergoing endovascular and surgical revascularisation of renal artery stenosis caused by FMD, and to identify factors that influence the efficacy of treatment.…”