ارتفاع الضغط الوعائي الكلوي : مقاربات علاجية و مراجعة في الأدب الطبي

الملخص EN

Background & Objective: Hypertension is one of the most important cardiovascular risk factors.

Renovascular hypertension is among its most common secondary causes, increasing cardiovascular adverse events, dialysis dependence if not treated and mortality.

To study severe hypertension pathology in renovascular disease, to evaluate therapeutic approaches (endovascular or surgery) and their results, and finally to review the most important studies about this subject.

Methods & Materials: A Retrospective study , between the beginning of 2010 and the middle of 2013, of severe hypertension with/without renal failure in 8 patients with uni or bilateral renal artery diseases who had 10 kidney revascularizations (9 endovascular and 1 surgical).

Results: The medical files of 8 patients with 10 renal artery diseases were reviewed.

There were 2 cases of stenosis of one renal artey and occlusion of the contralateral artery, and 6 cases with unilateral renal artery stenosis.

We had 10 kidney revascularization procedures, 9 endovascular (8 angioplasty-stenting ones and 1 recanalization- stenting) and one surgical revascularization procedures.

Follow up for 1-30 months (median 12 months), we have observed total remission of hypertension in 6 patients, while the other 2 patients continued to take one (in one patient) and two (in the other patient) antihypertensive drugs, because of persistence of hypertension, related to restenosis after 6 months in the first patient and immune systemic disease (cortisone dependent) in the second patient.

Conclusion: The study revealed good results with no complication after vascular interventions in patients with renovascular hypertension.

These results are compared to international studies can be considered good and permanent.