RT Journal Article
SR Electronic
T1 Angioplasty for renovascular hypertension in 78 children
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 474
OP 478
DO 10.1136/archdischild-2013-305886
VO 100
IS 5
A1 Jameela A Kari
A1 Derek J Roebuck
A1 Clare A McLaren
A1 Meryl Davis
A1 Michael J Dillon
A1 George Hamilton
A1 Rukshana Shroff
A1 Stephen D Marks
A1 Kjell Tullus
YR 2015
UL http://adc.bmj.com/content/100/5/474.abstract
AB Objectives To evaluate the outcome of percutaneous transluminal angioplasty (PTA) in children with renovascular hypertension (RVH) treated at a single centre over 29 years. Methods A retrospective study of the medical charts of all children with RVH who underwent PTA between 1984 and 2012. The primary outcome measurement was blood pressure (BP) achieved after the procedure. The BP before the procedure was compared with that at last available follow-up, 6 (range 0.6–16) years after the initial procedure. Results Seventy-eight children with median (range) age of 6.5 (0.5–17) years were studied. Twenty-three (29.5%) had an underlying syndrome, 35 (44.9%) children had bilateral renal artery stenosis (RAS), 18 (23%) intrarenal disease and 11(14%) showed bilateral RAS and intrarenal disease. Twenty (25.6%) children had mid-aortic syndrome and 14 (17.9%) cerebrovascular disease. One hundred and fourteen PTA procedures were carried out including 31 stent insertions. Following PTA, BP was improved in 49 (62.8%) children and of those 18 (23.1%) were cured. Children with involvement of only the main renal arteries showed improved BP control in 79.9% of the children with cure in 39.5%. BP was intentionally maintained above the 95th centile for age and height in four children with coexistent cerebrovascular disease. No change in BP was seen in 18 children despite observed technical success of the PTA, and in seven children due to technical failure of the procedure. Conclusions PTA provided a clinical benefit in 62.8% of children with RVH.