Reconstruction for renal artery aneurysm and its effect on hypertension.

OBJECTIVES many renal artery aneurysms (RAA) are diagnosed incidentally in the course of investigations for hypertension and their management is controversial. AIM to review the results of renal artery reconstruction for RAA. METHODS between January 1978 and December 1998 111 RAR were performed in 81 kidneys in 71 patients. RESULTS fifty-nine patients were hypertensive, three had a creatinine >2.0 mg/dl and one was on dialysis. The principal underlying pathology was fibromuscular dysplasia (39) and atherosclerosis (17). The mean RAA diameter was 2.2 (range 1-15) cm overall and 3.5 (range 2-10) cm in four patients who presented with rupture. Fifty-one patients had renal artery stenosis. Autogenous material was used in 105 RAR. There was no 30-day mortality and the morbidity rate was 16%. The 5-year cumulative patency rate was 69%. Hypertension was cured in 25% and improved in 39%. CONCLUSIONS RAR tested for RAA treats hypertension and reduces the risk of rupture and distal embolisation.