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A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
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Renovascular hypertension in children
Premal Amrishkumar Patel1, Anne Marie Cahill2
1Interventional Radiology, Radiology Department, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK. premalpatel@doctors.org.uk.
CVIR Endovascular
|January 7, 2021
Summary
Pediatric renovascular hypertension (RVH), a common cause of high blood pressure in children, is diagnosed using angiography. Angioplasty is the preferred intervention, with surgery considered before stenting for better outcomes.
Area of Science:
- Pediatric Nephrology
- Interventional Cardiology
- Pediatric Hypertension
Background:
- Pediatric hypertension, defined as systolic blood pressure >95th percentile, is often incidentally diagnosed.
- Renovascular hypertension (RVH) accounts for 5-25% of pediatric hypertension cases.
- Conditions like fibromuscular dysplasia, Williams syndrome, and Neurofibromatosis type 1 are associated with renal artery stenosis and middle aortic syndrome.
Purpose of the Study:
- To discuss diagnostic approaches for pediatric renovascular hypertension.
- To review interventional management strategies and outcomes for pediatric RVH.
- To highlight the preferred treatment options for renovascular disease in children.
Main Methods:
- Angiography is the gold standard for diagnosing renovascular disease in children.
- Evaluation of interventional procedures including angioplasty and stenting.
- Consideration of surgical options versus endovascular interventions.
Main Results:
- Angioplasty demonstrates benefit in the majority of pediatric patients with RVH.
- Repeated angioplasty is generally preferred over stenting.
- Endovascular intervention is the preferred treatment option due to established safety and success.
Conclusions:
- Angiography is crucial for diagnosing pediatric renovascular hypertension.
- Endovascular interventions, particularly angioplasty, are highly effective for managing pediatric RVH.
- Surgical intervention should be considered before stenting, except in emergent situations.
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