Angioplasty for pediatric renovascular hypertension: a 13-year experience

Angioplasty for pediatric renovascular hypertension: a 13-year experience

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PURPOSEWe aimed to evaluate the long-term outcome and efficacy of percutaneous transluminal renal angioplasty (PTRA) for pediatric renal artery stenosis (RAS), which is an important cause of medication-refractory pediatric hypertension.MATERIALS AND METHODSWe retrospectively evaluated 22 hypertensive children (age range, 3–17 years) who underwent PTRA from F-type February 2000 to July 2012.Sixteen patients had Takayasu arteritis and six fibromuscular dysplasia.

Five were not included in the statistical analysis due to loss to follow-up.RESULTSTechnical success was achieved in 32 of 34 procedures (94.1%).

The stenosis rate decreased from 84.5% before PTRA to 20.1% after PTRA.

Treatment was effective in 72.7% (16/22) of patients, including complete cure in 27.3% (6/22) and Bushings improvement in 45.

5% (10/22).Systolic and diastolic blood pressures decreased from 153±19.1 to 131.

7±21.4 mmHg and from 97.9±14.

2 to 83.6±19.3 mmHg, respectively (P < 0.

01).Number of antihypertensive agents decreased from 2.7 to 0.

5 per patient.Restenosis was detected in 40.9% (9/22) of patients, with a restenotic interval of 11.

8 months (range, 3–47 months).Lesion length was strongly correlated with clinical success (cure and improvement) (independent-sample t test, P < 0.001; binary logistic regression, P = 0.

040).CONCLUSIONLesion length is an important determination of clinical success with PTRA for pediatric RAS.PTRA is an appropriate treatment option for pediatric renovascular hypertension due to Takayasu arteritis and fibromuscular dysplasia.