Renal Artery Stenosis: III. Follow-up Observations in Operated and Non-operated Patients

Abstract

Of 240 hypertensives with arteriographically defined renal artery stenosis, 74 were operated upon. Excluding 7 patients operated with the chief objective of relieving uremia, and 6 who died within 3 weeks after the operation, 61 patients remained for a follow-up study. Follow-up times in the operated and non-operated patients varied between 1 and 10 years. The dominating effect of atherosclerosis on mortality was clearly evident in both series. Of 9 late deaths in the operated group, 6 consistently had diastolic levels of < 100 mm Hg. Several striking instances of complete normotension without drugs were observed, particularly in hypertensives with eye grounds Grades IV and III. The material was divided into patients with signs of extrarenal major artery disease, and patients without. The operated group clearly represented a selection of the least damaged of the group with definite extrarenal disease signs. In the group without such signs, the operation lead to somewhat better control and fewer deaths. This might possibly be taken as an indication of a favourable trend, but the material is too small and observation times too short to warrant definite conclusions.