Angioplasty for Renovascular Hypertension in Children: 20-Year Experience

Shroff, Rukshana; Roebuck, Derek J.; Gordon, Isky; Davies, Roger P.; Stephens, Suzanne; Marks, Stephen D.; Chan, M.K.H.; Barkovics, Maria; McLaren, Clare A.; Shah, Vanita; Dillon, Michael J.; Tullus, Kjell

doi:10.1542/peds.2005-2642

Cited by 148 publications

(133 citation statements)

References 39 publications

(59 reference statements)

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“…This can be achieved through percutaneous angioplasty and surgical interventions. In severe cases, where none of the previous treatments is successful, a nephrectomy is an alternative [1][2][3][4][5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous transluminal renal angioplasty has been considered the treatment of choice for revascularization [1,[4][5][6]. In cases, angioplasty had been reported as very useful, but other authors have reported poor long-term results needing the use of stents [1,[10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…The use of stents has proven to be of great benefit for the arterial revascularization, improving the renal function and controlling the hypertension. It has become the recommended treatment for severe stenosis and difficult lesions such as ostial and restenotic lesions [1,[4][5][6][7]. We took this line of treatment for our patient, since the preferred route was less invasive, and the angioplasty alone was not successful at long term as desired.…”

Section: Discussionmentioning

confidence: 99%

“…We took this line of treatment for our patient, since the preferred route was less invasive, and the angioplasty alone was not successful at long term as desired. However, authors have reported that the use of BMS may have a high incidence of restenosis [5]. DES or surgery has been used for such cases.…”

Section: Discussionmentioning

confidence: 99%

“…The physician's goal with these patients must be to control blood pressure and avoid future complications as is usually seen with long standing hypertension and renal failure. Treatments include medications, surgical procedures, and, for approximately the last 2 decades, percutaneous interventions [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of a recurrent renal artery stenosis and stent fracture using a drug eluting stent in a pediatric patient

Arce-Santiago

Rodríguez‐Cruz

2015

CEN Case Rep

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Renal artery obstruction is uncommon in the pediatric population and therefore represents a challenging diagnosis to ascertain and treat. While angioplasty and surgery have been used to treat it, stent implantation has been left mainly for adult use. In the following paper, we expose the case of an 8-year-old female who presented with severe arterial hypertension. Initially, the patient was evaluated and up to 5 antihypertensive medications were started. After complete evaluation, she was found to have severe right renal artery distal and proximal stenosis. She underwent recurrent angioplasties and then a bare metal stent (BMS) implantation, due to recurrence of stenosis. The original BMS developed a circumferential fracture, leading to a second stent implant, this time using a drug eluting stent (DES). She has been stable for 8 years since the last intervention, although using 2 antihypertensive medications. The use of BMS and DES may add another tool in the armamentarium of the pediatric interventionist to treat these children with recurrent stenosis that fail angioplasty.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Treatment of a recurrent renal artery stenosis and stent fracture using a drug eluting stent in a pediatric patient

Arce-Santiago

Rodríguez‐Cruz

2015

CEN Case Rep

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Persistent Hypertension Despite Successful Dilation of a Stenotic Renal Artery in a Boy With Neurofibromatosis Type 1

Ueda

Awazu

Konishi

et al. 2013

American J of Med Genetics Pt A

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Hypertension is one of the major complications in neurofibromatosis type 1 (NF1). It is known to be caused by renal artery stenosis or pheochromocytoma. However, more than half of hypertensive patients with NF1 do not have either disorder. We report here on a 13-year-old male with NF1 who had hypertension and a stenosis of the right renal artery associated with elevated renal vein renin on the diseased side. He underwent percutaneous transluminal renal angioplasty. In spite of successful dilation of the artery and normalized renin level, high blood pressure persisted beyond 6 months requiring antihypertensive medication. His wide pulse pressure suggested arterial stiffness due to NF1 vasculopathy. We posit that the cause of hypertension in this patient was considered to be arterial stiffness ascribed to NF1 vasculopathy rather than renal artery stenosis. Increased pulse pressure supports the hypothesis. This marker of arterial stiffness can be assessed non-invasively and should be evaluated routinely in NF1.

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Sonographic diagnosis of mid‐aortic syndrome in a 2‐year‐old patient with hypertension

Thomas

Bourke

Varcoe

et al. 2017

Australas J Ultrason Med

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Angioplasty for Renovascular Hypertension in Children: 20-Year Experience

Abstract: Angioplasty produced clinically worthwhile improvement for approximately 50% of patients. High incidence rates of extrarenal involvement and intrarenal disease and a high restenosis rate after stenting accounted for poor blood pressure control in the rest.

Cited by 148 publications

References 39 publications

Treatment of a recurrent renal artery stenosis and stent fracture using a drug eluting stent in a pediatric patient

Treatment of a recurrent renal artery stenosis and stent fracture using a drug eluting stent in a pediatric patient

Persistent Hypertension Despite Successful Dilation of a Stenotic Renal Artery in a Boy With Neurofibromatosis Type 1

Sonographic diagnosis of mid‐aortic syndrome in a 2‐year‐old patient with hypertension

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