Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, People's Republic of China.
Department of Radiology, Children's Hospital of Fudan University, Shanghai, People's Republic of China.
J Vasc Interv Radiol. 2022 Apr;33(4):399-407. doi: 10.1016/j.jvir.2021.10.035. Epub 2021 Dec 9.
To evaluate the midterm outcomes of percutaneous transluminal renal angioplasty (PTRA) for pediatric renovascular hypertension (RVH).
The clinical data of patients who underwent PTRA for RVH in the authors' hospital from 2012 to 2019 were retrospectively analyzed. Postprocedural blood pressure, glomerular filtration rate (GFR) of the affected kidney, restenosis, and complications were closely monitored.
PTRA was performed in a total of 30 children (20 boys and 10 girls), with a mean age of 7.3 years ± 0.7 (range, 40 days to 13.9 years) and a mean weight of 25.0 kg ± 2.3 (range, 3.4-53 kg). The median follow-up period was 26.5 months (range, 1 month to 7.5 years). Technical success was achieved in 26 (86.7%) of the 30 patients. Restenosis developed in 3 patients (10.0%). Only 1 patient underwent stent implantation, and the stent fractured 8 months later, requiring further intervention. There were no other complications. In terms of clinical benefit of blood pressure control after the initial PTRA procedure, 15 patients (50%) were cured and 7 patients (23.3%) showed improvement. There was no significant difference in the etiology, lesion location, and lesion length between patients with clinical benefit and failure (P = .06, P = .202, and P = .06, respectively). GFR of the affected kidney was significantly improved from 19.9 mL/min ± 11.2 to 38.1 mL/min ± 11.9 at the 6-month follow-up after PTRA (P < .001).
The overall results of PTRA for pediatric RVH caused by different etiologies are promising. PTRA not only provided a clinical benefit of blood pressure control in 73.3% of the patients but also significantly improved the function of the affected kidney.
评估经皮腔内肾血管成形术（PTRA）治疗小儿肾血管性高血压（RVH）的中期结果。
回顾性分析 2012 年至 2019 年在作者医院接受 PTRA 治疗 RVH 的患者的临床资料。密切监测术后血压、患肾肾小球滤过率（GFR）、再狭窄和并发症。
共 30 例儿童（20 名男孩，10 名女孩）接受 PTRA 治疗，平均年龄 7.3 岁±0.7（范围 40 天至 13.9 岁），平均体重 25.0kg±2.3（范围 3.4-53kg）。中位随访时间为 26.5 个月（范围 1 个月至 7.5 年）。30 例患者中，26 例（86.7%）手术技术成功。3 例（10.0%）发生再狭窄。仅 1 例患者植入支架，8 个月后支架断裂，需进一步介入治疗。无其他并发症。在初始 PTRA 术后血压控制的临床获益方面，15 例（50%）患者治愈，7 例（23.3%）患者改善。临床获益和失败患者的病因、病变部位和病变长度无显著差异（P=0.06，P=0.202，P=0.06）。PTRA 后 6 个月，患肾 GFR 从 19.9ml/min±11.2 显著改善至 38.1ml/min±11.9（P<0.001）。
不同病因所致小儿 RVH 的 PTRA 总体结果有前景。PTRA 不仅为 73.3%的患者提供了血压控制的临床获益，还显著改善了患肾功能。
