Percutaneous Transluminal Angioplasty (PTRA) in Children. Correlation
between Morphology of the Stenosis and PTRA Outcome
Peregrin J. H.1, Kolský A.2, Stříbrná J.1, Kováč J.1
Základna radiodiagnostiky a intervenční radiologie IKEM, Praha1 přednosta doc. MUDr. J. Peregrin, CSc. Dětská klinika IPVZ FTN, Praha2 vedoucí doc. MUDr. I. Novák, CSc. |
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Summary:
Aim of study: Retrospective analysis of PTRA performed in IKEM in the years 1982–2002 in children.
Correlation between morphological appearance of the stenosis and technical outcome of PTRA.
Material and methods: PTRA was performed in 28 children below the age of 18, in 18 boys and 10
girls, average age 12.4±2.8 years (6–18). Altogether 32 arteries were dilated (twice bilateral lesions,
once three arteries), 29 stenoses, 3 total occlusions. In 25 children the stenosis was caused by
fibromuscular dysplasia, in two children by arteritis and in one by neurofibromatosis. 15 lesions
were ostial, 2 proximal, 5 in the distal part of the main renal artery and 10 lesions were located in
peripheral renal artery branches. All angioplasties were performed because of difficult to control
hypertension combined with renal insufficiency in one patient.
Results: Technical success was achieved in all 15 distal/peripheral lesions. Out of 17 ostial/proximal
lesions technical success was achieved in three only. In another 9 lesions the outcomewas evaluated
as partial technical success and in another 5 authors completely failed to dilate the lesion (3 of them
were PTRA attempts in totally occluded arteries). In all PTRA with successful technical results the
hypertension was significantly easier to control.
Conclusion: Morphology of the renal artery stenosis in children correlates closely with PTRA
technical outcome. Dilatation of ostial/proximal lesions has a much worse prognosis than distal/peripheral
lesions.
Key words:
vasorenal hypertension – PTA – pediatric patients – fibromuscular dysplasia
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