Coarctation of the abdominal aorta and renal artery stenosis related to an umbilical artery catheter placement in a neonate.
Umbilical artery catheters have been associated with thrombotic complications, such as partial or complete occlusion in the aorta, the renal arteries, and other blood vessels. There have been few reports of the long-term consequences of either symptomatic or asymptomatic thrombi. We report a patient, now 22 years of age, born with a normal aorta, who developed hypertension at the age of 2 months after use of an umbilical artery catheter. An intravenous pylegram and nuclear renal scan were compatible with occlusion of left renal artery and of the distal aorta. At 6 months of age, the patient presented with reduced femoral pulses. Angiography demonstrated an acquired coarctation of the abdominal aorta and renal artery stenosis. An abdominal ultrasound performed at 22 years of age revealed partial obstruction of the lower abdominal aorta and marked atrophy of the left kidney. This case underlines the importance of long-term follow-up studies of infants who have undergone umbilical artery catheterizations.
Adelman
R D
RD
Phoenix Children's Hospital, Phoenix, Arizona, USA. radelman@phxchildrens.com
Morrell
R E
RE
D001012:Aorta, Abdominal / Q000473:pathology*; D001284:Atrophy / Q000209:etiology; D002408:Catheters, Indwelling / Q000009:adverse effects*; D003251:Constriction, Pathologic / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007668:Kidney / Q000473:pathology; D012078:Renal Artery Obstruction / Q000209:etiology*; D013927:Thrombosis / Q000150:complications / Q000209:etiology; D014469:Umbilical Arteries