Renovascular hypertension. Changing concepts in management.

The current approach to renovascular hypertension at the Lahey Clinic Medical Center consists of wider application of revascularization procedures than was possible a decade ago. Surgery is more frequently advised in patients over 50 years of age, in patients with atherosclerotic disease, and in patients with azotemia to restore renal function. Revascularization is suggested in some patients with a totally occluded renal artery, and alternatives to aortorenal bypass are advocated when the aorta is diseased. Bench surgery is used when appropriate, and concomitant aortic replacement and renal revascularization are generally avoid.