title: Pediatric penetrating renal artery trauma: stent-graft treatment with 2-year follow-up.
abstract: OBJECTIVE
  To report the 2-year follow-up of a pediatric patient who underwent stent-graft repair for penetrating renal artery trauma.
  
  
  METHODS
  An 11-year-old boy presented with a single anterior abdominal stab wound. He was normotensive (110/70 mmHg) but tachycardic (120 bpm). A focused abdominal sonogram for trauma revealed significant free intraperitoneal fluid. He underwent an urgent laparotomy, during which a minor liver injury was repaired. A large, nonpulsatile, non-expanding, left-sided retroperitoneal hematoma was identified but not explored. The boy remained hemodynamically unstable, so diagnostic angiography was performed. A single left proximal renal artery perforation was found. The lesion was treated with a 6x17-mm balloon-expandable stent-graft. Completion angiography demonstrated an excellent proximal and distal seal, without evidence of extravasation. The patient's condition stabilized, and he recovered completely. Serial renal duplex scans up to 2 years have documented normal renal artery blood flow and no migration of the stent-graft; the kidneys are equal in size. The serum creatinine level remains normal.
  
  
  CONCLUSIONS
  In appropriately selected patients, transcatheter stent-graft placement is a promising new kidney salvage modality to treat renal artery injury in children. Serious concern remains regarding the placement of covered stents in the pediatric population, as the long-term durability and the adaptability of growing arteries to renal stents are not known.
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, The Netherlands.
authors.forename: Bart E
authors.initials: BE
authors.lastname: Muhs
authors.forename: Kim
authors.initials: K
authors.lastname: de Rooy
authors.forename: Michele H J
authors.initials: MH
authors.lastname: Goossens
authors.forename: William P
authors.initials: WP
authors.lastname: Mali
authors.forename: Frans L
authors.initials: FL
authors.lastname: Moll
authors.forename: Hence J M
authors.initials: HJ
authors.lastname: Verhagen
mesh_terms: D019917:Blood Vessel Prosthesis Implantation; D002648:Child; D006801:Humans; D007813:Laparotomy; D008297:Male; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D015607:Stents; D016896:Treatment Outcome; D014463:Ultrasonography; D014951:Wounds, Stab / Q000000981:diagnostic imaging / Q000601:surgery*