Surgical management of adult and pediatric renovascular hypertension

Open renal revascularization for arteriosclerotic and fibrodysplastic renovascular hypertension (RVH)1-9 in adults has been performed less often in recent years given the advances in endovascular therapy of these diseases. However, conventional open arterial reconstruction remains the mainstay of treatment for developmental pediatric RVH.10 Proper selection of adults and children for operative intervention requires evidence of a functionally important renal artery narrowing, responsible for alterations in blood flow and activation of the reninangiotensin system. Invariably, such individuals are on multiple antihypertensive drugs with continued difficulty in controlling their blood pressure.

Duke Scholars

Author Dawn M Coleman Surgery, Vascular and Endovascular Surgery