Percutaneous balloon and stent angioplasty in children with renal artery stenosis

Abstract

Background: Renal artery stenosis(RAS) is responsible for about 10% of secondary childhood hypertension that lead to end organ dysfunction and mortality. Angioplasty is gold intervention approach for stenosis treatment. However, there are rare studies in term of the pediatric RAS and angioplasty outcome in the children. Material and methods: In this Single-center, retrospective study, the medical records of pediatric RAS patients were analyzed who referred for Rajaei cardiovascular medical and research center of Tehran from 2005 to 2018. Of these, 13 patients underwent PTA (Percutaneous transluminal angioplasty) treatment. Demographic data, etiology, symptoms, presenting feature, stenosis, blood pressure, number of drugs, hematological and biochemical parameters, intervention type, treatment complication and echocardiography reports were reviewed. Statistical analysis was performed with SPSS Version 23 software package. Descriptive statistics, Chi square and Pearson correlation, parametric and non-parametric tests used for statistical analysis. Results: Our results showed headache and cardiovascular damage was most common presenting feature. PTA intervention is effective in order of 50% of patients that reduced the blood pressure and improved medical therapy. The numbers of administrated antihypertensive drugs were reduced after PTA therapy. Restenosis and contrast induced-nephropathy emerge as major complications. Higher stenosis present but not lesion length had a negative relationship with treatment success and outcome. Age, ESR and serum potassium levels predicted the treatment outcome significantly. Conclusion: In conclusion, this study confirm the effectiveness of PTA in the treatment of pediatric RAS but need more technical and biomedical improvement to yield higher success and outcome.

Keywords

• Hypertension
• Renal artery stenosis
• Angioplasty
• Pediatric