Secondary renal revascularization for recurrent renal artery stenosis.

Six patients are presented who underwent secondary renal revascularization for recurrent renal artery stenosis. The initial pathologic diagnosis was fibrous dysplasia in three patients and atherosclerosis in three patients. All patients had initially undergone a successful aortorenal bypass operation. Recurrent renal artery stenosis and hypertension developed 11 to 120 months later (mean, 58 months). Secondary revascularization operations included renal autotransplantation (2 patients), hepatorenal bypass (2), iliorenal bypass (1), and aortorenal bypass (1). Hypertension was relieved, and renal function was stabilized or improved in all cases. If hypertension recurs after renal revascularization, a recurrent but correctable lesion should be suspected.