Renal artery intervention in pediatric and adolescent patients: a 20-year experience.
Between 1986 and 2005, 22 patients (mean age, 14.7 years; range, 3-21) with renal hypertension underwent renal artery revascularization for 28 lesions, 23 with open repair (OR) and 5 with percutaneous transluminal renal angioplasty (PTRA). Thirty-day morbidity was 17% (4/23). Hypertension was cured in 13 (57%), improved in 8 (38%), and unchanged in 1 (5%). Renal function worsened in 1. At a mean follow-up of 4.9 years, 1-year patency rate was 94% and maintained for 5 years. Hypertension at 1 year was cured in 6 of 14 patients (43%; OR, 4; PTRA, 2) and improved in 8 (57%; OR, 7; PTRA, 1); hypertension at 5 years was cured in 50% and improved in 50%. Renal function remained unchanged in all patients who were followed. The authors conclude that both OR and PTRA benefit pediatric patients. PTRA for selected patients may be promising as a first line treatment or as a bridge to definitive OR in children with small arteries.
Huang
Ying
Y
Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota 55905, USA.
Duncan
Audra A
AA
McKusick
Michael A
MA
Milliner
Dawn S
DS
Bower
Thomas C
TC
Kalra
Manju
M
Gloviczki
Peter
P
Hoskin
Tanya L
TL
D000293:Adolescent; D000328:Adult; D000792:Angiography / Q000379:methods; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D007677:Kidney Function Tests; D018810:Magnetic Resonance Angiography; D008297:Male; D018579:Patient Selection; D012077:Renal Artery / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000009:adverse effects