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Renal Artery Intervention in Pediatric and Adolescent Patients: A 20-Year Experience

Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota

Audra A. Duncan, MD

Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota, duncan.audra{at}mayo.edu

Michael A. McKusick, MD

Department of Radiology, Mayo Clinic, Rochester, Minnesota

Dawn S. Milliner, MD

Division of Nephrology and Hypertension Mayo Clinic, Rochester, Minnesota

Thomas C. Bower, MD

From the Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota

Manju Kalra, MBBS

From the Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota

Peter Gloviczki, MD

From the Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota

Tanya L. Hoskin

From the Division of Vascular Surgery, Gonda Vascular Center, Mayo Clinic, Rochester, Minnesota

Between 1986 and 2005, 22 patients (mean age, 14.7 years; range, 3-21) with renal hypertension underwent renal artery revascularization for 28 lesions, 23 with open repair (OR) and 5 with percutaneous transluminal renal angioplasty (PTRA). Thirty-day morbidity was 17% (4/23). Hypertension was cured in 13 (57%), improved in 8 (38%), and unchanged in 1 (5%). Renal function worsened in 1. At a mean follow-up of 4.9 years, 1-year patency rate was 94% and maintained for 5 years. Hypertension at 1 year was cured in 6 of 14 patients (43%; OR, 4; PTRA, 2) and improved in 8 (57%; OR, 7; PTRA, 1); hypertension at 5 years was cured in 50% and improved in 50%. Renal function remained unchanged in all patients who were followed. The authors conclude that both OR and PTRA benefit pediatric patients. PTRA for selected patients may be promising as a first line treatment or as a bridge to definitive OR in children with small arteries.

Key Words: renal artery disease • hypertension • pediatric • adolescent • intervention

Vascular and Endovascular Surgery, Vol. 41, No. 6, 490-499 (2008)
DOI: 10.1177/1538574407307944


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