title: Renal denervation for severe hypertension in a small child with Turner syndrome: miniaturisation of the procedure and results.
abstract: Sympathetic nervous system hyperactivity plays a role in development and progression of hypertension. While renal denervation employing radiofrequency devices has been used therapeutically in treating severe hypertension with alternate results in adults, few data are available regarding children. We treated a 6-year-old girl affected by Turner syndrome presenting severe hypertension and an episode of stroke, in spite of treatment with four antihypertensive drugs, with sympathetic ablation. The Simplicity device (Medtronic, Minneapolis, USA) was adapted to the smaller vessels, allowing a tailored approach. After 3 and 6 months of treatment, and β-blocker discontinuation, blood pressure values were set between the 90th and 95th centiles for sex and age, and normalised at 12 months. We confirm that renal denervation can be used to treat severe hypertension in children; miniaturisation of catheter and tailoring the procedure for small vessels allowed a safe approach. Progressive improvement of blood pressure had a satisfactory clinical impact.
authors.affiliation: Division of Nephrology, Dialysis and Transplantation, Istituto G Gaslini, Genoa, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Bonanni
authors.affiliation: Interventional Radiology and Neuroradiology Unit, Istituto G Gaslini, Genoa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Pasetti
authors.affiliation: Division of Nephrology, Dialysis and Transplantation, Istituto G Gaslini, Genoa, Italy.
authors.forename: Gian Marco
authors.initials: GM
authors.lastname: Ghiggeri
authors.affiliation: Interventional Radiology and Neuroradiology Unit, Istituto G Gaslini, Genoa, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Gandolfo
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000601:surgery*; D008904:Miniaturization; D011859:Radiography; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000294:innervation* / Q000601:surgery*; D020521:Stroke / Q000209:etiology; D013562:Sympathectomy / Q000295:instrumentation / Q000379:methods*; D014424:Turner Syndrome / Q000150:complications*
chemical_list: D000959:Antihypertensive Agents