Successful percutaneous transluminal angioplasty for treatment of renovascular hypertension in a 15-month-old child

Hofbeck, Michael; H, Singer; Rupprecht, Tobias A.; Ruder, H.; Schmiedl, Norbert

doi:10.1007/s004310050866

Cited by 16 publications

(7 citation statements)

References 8 publications

(10 reference statements)

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“…Generally good results outweigh by far the risks of recurrent stenosis and rare but severe complications such as dissection or rupture of the dilated vessel resulting in complete vessel occlusion, retroperitoneal bleeding or aneurysm formation [4,14,15]. However, there are only a few reports in the literature for an age of less than 4 y [5,6]. In infants, the practicability of this technique is limited due to the small size of their vessels.…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous transluminal angioplasty for renovascular hypertension in a neonate

Dähnert¹,

Hennig²,

Scheinert³

2005

Acta Paediatrica

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Section: Discussionmentioning

confidence: 99%

“…Application of an age-adapted technique has been described for individual patients. There are reports of a 9-mo-old hypertensive girl with congestive heart failure [5] and a 15-mo-old hypertensive child with secondary hypertension due to renal artery stenosis [6]. We report on the first intervention for treatment of renovascular hypertension in a neonate.…”

mentioning

confidence: 93%

Percutaneous transluminal angioplasty for renovascular hypertension in a neonate

Dähnert¹,

Hennig²,

Scheinert³

2005

Acta Paediatrica

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“…Therefore, medical therapy accompanied by little compensatory renin release and minimal effect on glomerular filtration rate, such as labetalol and alpha-adrenergic blocking agents, is preferred. PTA is less invasive than open surgery, but the overall experience in small children is limited [5,19]. Potential complications of PTA include hemorrhage or hematoma at the puncture site, transient renal failure induced by contrast media, spasm of the renal artery, embolization of the kidney, renal infarction, dissection, perforation or rupture of the renal vessels, anuria and balloon rupture.…”

Section: Discussionmentioning

confidence: 98%

Severe renovascular hypertension in an infant with congenital solitary pelvic kidney

et al. 2005

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Renal artery stenosis (RAS) is one of the most common causes of severe arterial hypertension in infants. Its management is very difficult, especially when present in a single kidney. We report a case of severe hypertension caused by RAS of congenital single pelvic kidney in a 4-month-old boy. The patient presented with cardiorespiratory insufficiency that was first treated as acute fulminate myocarditis. Medical treatment of arterial hypertension was disappointing, as it had to be balanced between congestive cardiac failure and acute renal failure. Percutaneous transluminal angioplasty (PTA) done by coronary balloon dilatation catheters through the left axillary access was successful. Following dilatation of the renal artery, blood pressure decreased and its good control was possible by only one drug. With improved medical blood pressure control and normal growth development, the reassessment of clinical therapy options adjusted to a larger vessel size would be possible. Renovascular hypertension due to RAS in infants with a solitary kidney is difficult to control by medical treatment alone. PTA should be considered as a viable option in infants with refractory hypertension due to renal artery stenosis in a solitary kidney, since it has the potential of improving hypertension while preserving renal function.

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“…Generally good results outweigh by far the risks of recurrent stenosis and rare but severe complications such as dissection or rupture of the dilated vessel resulting in complete vessel occlusion, retroperitoneal bleeding or aneurysm formation 4, 14, 15. However, there are only a few reports in the literature for an age of less than 4 y 5, 6. In infants, the practicability of this technique is limited due to the small size of their vessels.…”

Section: Discussionmentioning

confidence: 99%

“…Application of an age‐adapted technique has been described for individual patients. There are reports of a 9‐mo‐old hypertensive girl with congestive heart failure 5 and a 15‐mo‐old hypertensive child with secondary hypertension due to renal artery stenosis 6. We report on the first intervention for treatment of renovascular hypertension in a neonate.…”

mentioning

confidence: 96%

Percutaneous transluminal angioplasty for renovascular hypertension in a neonate

2005

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Aim: To report on the first case of successful percutaneous transluminal renal artery angioplasty in a neonate. Methods: Case report: a 5‐d‐old neonate was admitted with cardiorespiratory failure. Monitoring of blood pressure revealed severe arterial hypertension. Doppler sonography detected stenotic flow in the right renal artery. A 99mTc‐MAG3 scan revealed highly diminished elimination by the right kidney. Selective renin levels were 23 968 ng/l in the right and 3770 ng/l in the left renal vein and the aorta. Percutaneous transluminal angioplasty using a 2×10 mm balloon catheter was performed on the 8th day of life. Results: The patient was discharged from hospital normotensive without anti‐hypertensive medication. During 8 mo follow‐up the blood pressure remained normal, Doppler sonography revealed no recurrent artery stenosis, and renal function improved. Conclusion: Neonatal percutaneous transluminal angioplasty for renal artery stenosis may be feasible in selected patients.

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Successful percutaneous transluminal angioplasty for treatment of renovascular hypertension in a 15-month-old child

Abstract: Percutaneous transluminal angioplasty of renal artery stenosis can be performed safely in young children using equipment originally designed for treatment of coronary artery stenosis in adults.

Cited by 16 publications

References 8 publications

Percutaneous transluminal angioplasty for renovascular hypertension in a neonate

Percutaneous transluminal angioplasty for renovascular hypertension in a neonate

Severe renovascular hypertension in an infant with congenital solitary pelvic kidney

Percutaneous transluminal angioplasty for renovascular hypertension in a neonate

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