Percutaneous Transluminal Angioplasty for Renovascular Hypertension in Children: Initial and Long-term Results

Tyagi, Sanjay; Kaul, U; Satsangi, Deepak Kumar; Arora, Ramesh

doi:10.1542/peds.99.1.44

Cited by 126 publications

(97 citation statements)

References 24 publications

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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%

“…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: Introductionmentioning

confidence: 99%

See 2 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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“…The long-term success rate seems, at present, to be between 50 and 90% with technical failures or late stenosing events being the most important problems [3,[10][11][12]. The technical failures are with increasing experience and improving equipment getting less common.…”

Section: Angioplasty With or Without Stentingmentioning

confidence: 99%

Renal artery stenosis: is angiography still the gold standard in 2011?

Tullus

2011

Pediatr Nephrol

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Renovascular hypertension (RVH) is an unusual cause of hypertension in children that is important to diagnose as it is potentially curable with angioplasty or surgery. Digital subtraction angiography is the gold standard for diagnosing RVH; for other methods like ultrasound, isotope studies, magnetic resonance angiography and computed tomography angiography sensitivity is still too low to reliably exclude RVH. Clinical and laboratory criteria that suggest RVH will be proposed and recommendations when digital subtraction angiography should be performed will be made. A treatment algorithm that suggests when to use medical treatment, interventional radiology and surgery in children with RVH will be given.

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Successful management of a resistant renal artery stenosis in a child using a 4 mm cutting balloon catheter

Haas¹,

Ocker²,

Knirsch³

et al. 2002

Cathet Cardio Intervent

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Percutaneous transluminal renal angioplasty (PTRA) is a well-established method to treat renal artery stenosis (RAS) in children and adults. However, a significant number of stenoses might not be treated by interventional techniques due to the inability to dilate the RAS. Conventional balloon angioplasty with a high-pressure coronary angioplasty balloon at 20 atm was unable to dilate a significant RAS in a 12-year-old child with severe renovascular hypertension (RR 195/125 mm Hg). After using a 4 mm cutting balloon, we achieved wide patency of the renal artery and an instant normalization of blood pressure without further need of antihypertensive therapy. PTRA using the cutting balloon technique may offer an additional therapeutic option for selected patients in whom conventional balloon angioplasty was not able to dilate RAS.

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Percutaneous Transluminal Angioplasty for Renovascular Hypertension in Children: Initial and Long-term Results

Abstract: Aortoarteritis is the most common cause of renovascular hypertension in South Asian children. PTRA is safe and highly effective and therefore should be the treatment of choice in pediatric renovascular hypertension.

Cited by 126 publications

References 24 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

Renal artery stenosis: is angiography still the gold standard in 2011?

Successful management of a resistant renal artery stenosis in a child using a 4 mm cutting balloon catheter

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