Late results of aortorenal bypass.

Much of the controversy about operative intervention for renovascular hypertension stems from reports that show a low rate of blood pressure benefit, a high technical failure rate of revascularization, or a high operative risk. Current results in centers having a large operative experience with the management of renovascular hypertension, however, demonstrate the practical value of aortorenal bypass. At Vanderbilt University, sequential angiographic study demonstrates that most bypass grafts (88 per cent) remain stable, with no adverse changes during long-term follow-up. Similarly, comparison of initial blood pressure response to blood pressure status after 15 to 20 years shows that the benefit of aortorenal bypass is maintained.