Varghese Kiron, Adhyapak Srilakshmi M, Lohitashwa S B, Pais Priya, Iyengar Arpana A
Department of Cardiology, St. John's Medical College Hospital, Bangalore, 560034, India.
Department of Pediatric Nephrology, St. John's Medical College Hospital, Bangalore, India.
Cardiovasc Interv Ther. 2017 Jul;32(3):274-278. doi: 10.1007/s12928-016-0415-z. Epub 2016 Jul 22.
The occurrence of vascular lesions in neurofibromatosis is uncommon but well documented. These vascular lesions when present, occur predominantly in the kidneys, endocrine glands, heart and gastrointestinal tract, causing stenosis or obliteration of the lumen. We report a case of uncontrolled resistant hypertension in a 2-year-old child presenting with neurofibromatosis who was found to have a high-grade ostial left renal artery stenosis and obliteration of the right renal artery. As the right kidney was small and hypo-functioning, and its renal artery was totally occluded, we subjected the child to a left renal angioplasty and bailout stenting. Following stenting, the blood pressure decreased with anti-hypertensive treatment. Based on a review of the literature, and to the best of our knowledge, this is the youngest child to have undergone renal artery stenting.
神经纤维瘤病中血管病变的发生并不常见,但有充分的文献记载。这些血管病变一旦出现,主要发生在肾脏、内分泌腺、心脏和胃肠道,导致管腔狭窄或闭塞。我们报告了一例2岁患有神经纤维瘤病的儿童出现难以控制的顽固性高血压,经检查发现其左肾动脉起始部高度狭窄且右肾动脉闭塞。由于右肾体积小且功能减退,其肾动脉完全闭塞,我们对该患儿进行了左肾血管成形术及补救性支架置入术。支架置入术后,经降压治疗血压下降。据文献回顾及我们所知,这是接受肾动脉支架置入术的最年幼患儿。