THERAPY OF RENOVASCULAR HYPERTENSION IN N EUROFIBROMATOSIS - OPERATIVE REVASCULARIZATION VERSUS PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY

Vasculopathy is a rare and undervalued complication in neurofibromatos is. Histopathological changes of the vascular wall may lead to relevan t renal artery stenosis. We report a case of a 17-year-old patient wit h neurofibromatosis and severe renovascular hypertension resulting fro m a proximal renal artery stenosis. Attempted percutaneous renal angio plasty was unsuccessful and the patient was referred for operative rev ascularization. After insertion of an aortorenal bypass with a reverse d saphenous vein graft the patient became normotensive without medicat ion. Based on our own experience and a review of the literature we rec ommend operative reconstruction of stenotic renal arteries in neurofib romatosis.