Anatomic distribution of renal artery stenosis in children: implications for imaging.

Abstract:

BACKGROUND:Renal artery stenosis (RAS) causes significant hypertension in children. Frequently, pediatric RAS occurs with systemic disorders. In these cases, stenoses are often complex and/or include long segments. We believed that hypertensive children without comorbid conditions had a different lesion distribution and that the difference might have implications for imaging and treatment. OBJECTIVE:To identify locations of RAS lesions in these hypertensive children without comorbid conditions. MATERIALS AND METHODS:Patients who had renal angiography for hypertension from 1993 to 2005 were identified. Patients with systemic disorders, renovascular surgery, or normal angiograms were excluded. The angiograms of the remaining patients were reviewed for number, type, and location of stenoses. RESULTS:Eighty-seven patients underwent renal angiography for hypertension; 30 were excluded for comorbid conditions. Twenty-one of the remaining 57 patients had abnormal angiograms; 24 stenoses were identified in those patients. All were focal and distributed as follows: 6 (25%) main renal artery, 12 (50%) 2nd order branch, 3 (12.5%) 3rd order branch, and 3 (12.5%) accessory renal artery. CONCLUSION:Hypertensive children without comorbid conditions who have RAS usually have single, focal branch artery stenoses. This distribution supports angiography in these patients because of its superior sensitivity in detecting branch vessel disease and its therapeutic role in percutaneous transluminal renal angioplasty.

journal_name

Pediatr Radiol

journal_title

Pediatric radiology

authors

Vo NJ,Hammelman BD,Racadio JM,Strife CF,Johnson ND,Racadio JM

doi

10.1007/s00247-006-0253-8

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

1032-6

issue

10

eissn

0301-0449

issn

1432-1998

journal_volume

36

pub_type

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