Cutting balloon angioplasty in children with resistant renal artery stenosis.
Children with systemic hypertension resulting from a renovascular stenosis commonly have fibromuscular dysplasia and respond to percutaneous transluminal renal angioplasty (PTRA). There is a subset of children, however, with conditions that appear to be resistant to PTRA (eg, syndromic renal artery stenosis and arteritis). These patients are often treated surgically. The development of the cutting balloon may provide a minimally invasive alternative to surgery in these individuals. Associated adverse events may include recurrent stenosis, arterial occlusion with renal loss, and arterial rupture with extravasation and pseudoaneurysm formation. Some of these adverse events can be successfully treated with percutaneous interventional techniques. The authors present four cases of cutting balloon angioplasty performed at two large metropolitan children's hospitals in children with resistant renal artery stenosis.
Towbin
Richard B
RB
Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104, USA. rtowbin@gmail.com
Pelchovitz
Daniel J
DJ
Cahill
Anne Marie
AM
Baskin
Kevin M
KM
Meyers
Kevin E C
KE
Kaplan
Bernard S
BS
McClaren
Clare A
CA
Roebuck
Derek J
DJ
D000792:Angiography; D000800:Angioplasty, Balloon; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology; D008297:Male; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*