Percutaneous Balloon Angioplasty of Renovascular Hypertension in Pediatric Cases

Purpose : To investigate effectiveness of percutaneous transluminal renal angioplasty (PTRA) in treatment of renal artery stenoses due to Takayasu arteritis (TA), fibromuscular dysplasia (FMD) and neurofibromatosis (NF). Materials-methods : Between December 1991-October 2006, 20 pediatric cases (age range 3–18 years, meanly 12.5 year) with at least 60% stenoses were underwent PTRA. Main presenting symptom was hypertension. The aetiologies were TA in 12, and FMD in 5, NF in three cases.

Results : Totally, 46 procedures were performed on 35 stenotic segments of 20 cases. A technically good result was obtained in 21/24 arteries of TA patients, 7/7 arteries of FMD patients, and 1/3 arteries of NF1 patients. Clinical follow-up for a mean of 55.7 months revealed 100% success in all cases. Delayed clinical response was seen in two cases with Nf1. Restenosis was detected 5/12 of TA patients, 1/5 of FMD patients and 1/3 NF1 patients.

Conclusion : PTRA can be safely performed resulting in excellent angiographic and clinical results. It should be first choice in renal artery stenosis in pediatric age when medical treatment fails to control renovascular hypertension or renal function is decreasing although initial results might be not encouraging in NF1.