Renal Artery Reconstruction for Refractory Hypertension Caused by Congenital Renal Artery Deficiency

Ann Vasc Surg. 2021 Nov:77:352.e1-352.e5. doi: 10.1016/j.avsg.2021.05.062. Epub 2021 Aug 27.

Abstract

Renovascular hypertension is a common cause of secondary hypertension. According to the epidemiological survey, the prevalence of renovascular hypertension accounts for 1-5% of the population with hypertension. Most of the cases are associated with atherosclerosis and Fibromuscular Dysplasia (FMD). Owing to the lack of standard treatment, they will eventually develop into chronic kidney disease, which significantly affects the patient's quality of life. Hypertension is considered a prerequisite for renal artery surgery; renal function research is used to guide the treatment of unilateral lesions because endovascular intervention can only slightly improve hypertension and renal function. We advocate open surgery for patients with congenital dysplasia of renal vascular hypertension, in which the most common surgical operations are aortorenal artery bypass, renal artery endarterectomy, and renal artery replantation. This paper reports a rare case of renovascular hypertension. The patient was a 13-year-old female, and the operation was risky and complicated. He was diagnosed with a congenital absence of the right renal artery. The right renal function was recovered, and the blood pressure was well controlled after the Aorta-Right Renal Artery Bypass.

Keywords: Absence of right renal artery; Refractory hypertension; Renal artery reconstruction.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anastomosis, Surgical
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure* / drug effects
  • Female
  • Humans
  • Hypertension, Renovascular / diagnostic imaging
  • Hypertension, Renovascular / etiology
  • Hypertension, Renovascular / physiopathology
  • Hypertension, Renovascular / surgery*
  • Renal Artery / abnormalities
  • Renal Artery / diagnostic imaging
  • Renal Artery / physiopathology
  • Renal Artery / surgery*
  • Treatment Outcome
  • Vascular Grafting*
  • Vascular Malformations / complications
  • Vascular Malformations / diagnostic imaging
  • Vascular Malformations / physiopathology
  • Vascular Malformations / surgery*

Substances

  • Antihypertensive Agents