✦ Renal Artery Stenosis Treatment

Endarterectomy (Renal Artery Stenosis)

Q: When is endarterectomy chosen over PTRA?

Endarterectomy is preferred when concomitant aortic surgery is required, when calcification prevents stent expansion, or when stenting has previously failed.

Q: Does endarterectomy cure hypertension?

Hypertension improves or resolves in 75–85% of patients; the degree of benefit depends on duration of hypertension and degree of parenchymal damage.

Q: What is the risk of renal artery thrombosis after endarterectomy?

With meticulous technique, thrombosis risk is below 5%; intraoperative Doppler assessment confirms satisfactory flow before closure. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Surgical Removal of Atheromatous Plaque from the Renal Artery

2–4 Hours PROCEDURE

5–8 Days HOSPITAL STAY

>80% SUCCESS RATE

4–6 Weeks RECOVERY

What is Endarterectomy (Renal Artery Stenosis)?

Renal Artery Endarterectomy involves the surgical removal of the atheromatous plaque from within the renal artery ostium and proximal segment, restoring the native vessel lumen. It is particularly suited to ostial atherosclerotic stenosis with heavy calcification where stents do not expand well, or when concomitant aortic surgery for aneurysm or occlusive disease is being performed. Endarterectomy can achieve complete plaque removal with the renal artery repaired primarily or with a patch. The procedure is performed under general or spinal anaesthesia with a hospital stay of 5–8 Days.

Patients with ostial atherosclerotic renal artery stenosis requiring concomitant aortic surgery, or those with heavy calcification making endovascular stenting technically difficult. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Midline Laparotomy

Midline laparotomy; aorta and renal artery origins exposed and controlled.

Arterial Clamping & Arteriotomy

Renal artery clamped; longitudinal arteriotomy made over the stenotic segment.

Plaque Removal

Atheromatous plaque elevated and removed completely with an endarterectomy dissector.

Arteriotomy Closure

Intimal flap tacked down; arteriotomy closed primarily or with vein patch angioplasty.

Flow Restoration & Closure

Flow restored; haemostasis confirmed; closure in layers.

Outcomes

2–4 HoursDURATION

5–8 DaysHOSPITAL STAY

>80%SUCCESS RATE

4–6 WeeksFULL RECOVERY

Who Needs This Treatment?

→Removes the atherosclerotic plaque entirely — not just dilated past it.
→Ideal when concomitant aortic reconstruction is already planned.
→No foreign material (stent) left in the vessel.
→Excellent results for ostial disease where stents commonly restenose.
→Direct vision repair with tailored patch angioplasty if needed.
→Single operation addressing both aortic and renal artery disease simultaneously.

"Endarterectomy removes the problem at its source — the plaque itself. When combined with aortic surgery or for heavily calcified ostial stenoses, it provides clean, durable revascularisation that stenting cannot match."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

When is endarterectomy chosen over PTRA?+

Does endarterectomy cure hypertension?+

What is the risk of renal artery thrombosis after endarterectomy?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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