Outcomes of percutaneous transluminal angioplasty for pediatric renovascular hypertension.

BACKGROUND: Up to 10% of hypertensive children will have renovascular disease. Where medical therapy fails to control the hypertension, endovascular techniques can improve renal perfusion. The purpose of this study was to assess the efficacy of angioplasty in controlling renovascular hypertension (RVH) in children.

METHODS: This is a single-center, retrospective review of patients who underwent angioplasty for RVH between 1992 and 2009. All patients were selected from the Interventional Radiology database. The primary outcome measure was clinical success as reflected by a favorable, sustained response in blood pressure for at least 1year following the angioplasty.

RESULTS: Two hundred sixteen patients underwent diagnostic angiography for suspected RVH, of these 28 required 42 angioplasties. Ten (36%) were cured, 9 (32%) were improved and 9 (32%) failed to respond to treatment. Major complications occurred in three patients and minor complications occurred in 18 angioplasties. Fibromuscular dysplasia (FMD) was the most common diagnosis in this series and was associated with a 79% success rate.

CONCLUSION: In our exclusively pediatric population angioplasty safely improved blood pressure control in 68% of patients, more than half of which are cured. FMD appeared to have the best clinical outcomes in our series.