Hall Thomas C, Williams Alun, Hussain Farida, O'Neill Richard
Department of Interventional Radiology, Queen's Medical Centre (QMC), Nottingham University Hospitals NHS Trust, Nottingham, UK.
Department of Transplant Surgery, Nottingham City Hospital, Nottingham, UK.
Clin Med Insights Case Rep. 2019 Feb 7;12:1179547619828721. doi: 10.1177/1179547619828721. eCollection 2019.
Renovascular hypertension is a rare cause of paediatric hypertension. It is however, a potentially treatable cause particularly when caused by renal artery stenosis (RAS).
We present the case of an 11-month-old girl presenting with cardiac dysfunction. She was found to be hypertensive with a systolic blood pressure >180mmHg. DMSA demonstrated a small right kidney and a divided renal function of 6% on the right and 94% on the left. Spectral analysis demonstrated abnormal waveforms suggestive of RAS of the left kidney.
Angioplasty with a cutting balloon was successful. Blood pressure measurements, renal function and left ventricular function improved.
RAS can be successfully treated with cutting balloon angioplasty after failure of convention balloon angioplasty to relieve the narrowing. In our case, there was an immediate successful angiographic result that on mid-term follow-up demonstrated significant improvement in clinical and biochemical outcomes and cessation of all anti-hypertensive medication.
肾血管性高血压是儿童高血压的罕见病因。然而，它是一种潜在可治疗的病因，尤其是由肾动脉狭窄（RAS）引起时。
我们报告一例11个月大出现心脏功能障碍的女孩病例。发现她患有高血压，收缩压>180mmHg。二巯基丁二酸（DMSA）显示右肾小，右肾功能占比6%，左肾功能占比94%。频谱分析显示异常波形，提示左肾存在肾动脉狭窄。
使用切割球囊进行血管成形术成功。血压测量、肾功能和左心室功能均得到改善。
在传统球囊血管成形术未能缓解狭窄后，使用切割球囊血管成形术可成功治疗肾动脉狭窄。在我们的病例中，血管造影术即刻取得成功结果，中期随访显示临床和生化指标显著改善，所有抗高血压药物停用。
