REGULAR CONTENT
Final ID
642
Type
Educational Exhibit-Poster Only
Authors
K Vo1, E Monroe2, G Shivaram3
Institutions
1University of Washington School of Medicine, Seattle, WA, 2University of Washington, Seattle, WA, 3Seattle Children's Hospital, Seattle, WA
Purpose
To evaluate the clinical outcomes, safety, and efficacy of percutaneous transluminal renal angioplasty (PTRA) in children with renovascular hypertension (RVH) treated at a single center over 9 years, including the adjunctive use of intravascular ultrasound (IVUS) and pressure monitoring guidewires.
Materials & Methods
A retrospective review of data for hypertensive children (ages 1-18 years old) who underwent PTRA at a single center between October 2007 and August 2016 was performed. Patients who were either post-transplant or post-surgery were excluded. Procedural angiograms, along with available IVUS imaging and pressure measurements, were reviewed and correlated with chart data to determine safety, technical success, and clinical outcome. We defined clinical success as reduced medication units, as described by Srinivasan et al. [4] or resolution of hypertension in post-intervention nephrology or PCP follow-up.
Results
A total of 22 children underwent 34 PTRA procedures. 9 children had angiographic findings of fibromuscular dysplasia (FMD), 5 had Williams syndrome, and 2 had neurofibromatosis type 1. Technical success was achieved in 33 of 34 (97.1%) procedures. Intra-arterial IVUS was used in 4 of 34 (11.8%) procedures and pressure monitoring guidewires in 10 of 34 (29.4%) procedures. The number of complications encountered, all minor, was 4 of 34 (11.7%) procedures. Post-intervention, antihypertensive medication units were decreased in 15 of 22 (68.2%) children with a cure in 8 of 22 (36.4%). In the 10 procedures utilizing pressure monitoring guidewire, 5 (50%) obtained clinical success compared to 15 of 24 (62.5%) procedures without a guidewire. The most recent 6 procedures utilizing pressure monitor guidewire were clinically successful.
Conclusions
PTRA provided clinical benefit in 15 of 22 children with RVH (68.2%), which is concordant with previously published series [1, 2, 3, 4]. Use of intravascular ultrasound and pressure monitoring guidewire may increase the accuracy of intervention. Further investigation is necessary to determine if the clinical success rate of PTRA in children can be improved with the use of these tools.
Final ID
642
Type
Educational Exhibit-Poster Only
Authors
K Vo1, E Monroe2, G Shivaram3
Institutions
1University of Washington School of Medicine, Seattle, WA, 2University of Washington, Seattle, WA, 3Seattle Children's Hospital, Seattle, WA
Purpose
To evaluate the clinical outcomes, safety, and efficacy of percutaneous transluminal renal angioplasty (PTRA) in children with renovascular hypertension (RVH) treated at a single center over 9 years, including the adjunctive use of intravascular ultrasound (IVUS) and pressure monitoring guidewires.
Materials & Methods
A retrospective review of data for hypertensive children (ages 1-18 years old) who underwent PTRA at a single center between October 2007 and August 2016 was performed. Patients who were either post-transplant or post-surgery were excluded. Procedural angiograms, along with available IVUS imaging and pressure measurements, were reviewed and correlated with chart data to determine safety, technical success, and clinical outcome. We defined clinical success as reduced medication units, as described by Srinivasan et al. [4] or resolution of hypertension in post-intervention nephrology or PCP follow-up.
Results
A total of 22 children underwent 34 PTRA procedures. 9 children had angiographic findings of fibromuscular dysplasia (FMD), 5 had Williams syndrome, and 2 had neurofibromatosis type 1. Technical success was achieved in 33 of 34 (97.1%) procedures. Intra-arterial IVUS was used in 4 of 34 (11.8%) procedures and pressure monitoring guidewires in 10 of 34 (29.4%) procedures. The number of complications encountered, all minor, was 4 of 34 (11.7%) procedures. Post-intervention, antihypertensive medication units were decreased in 15 of 22 (68.2%) children with a cure in 8 of 22 (36.4%). In the 10 procedures utilizing pressure monitoring guidewire, 5 (50%) obtained clinical success compared to 15 of 24 (62.5%) procedures without a guidewire. The most recent 6 procedures utilizing pressure monitor guidewire were clinically successful.
Conclusions
PTRA provided clinical benefit in 15 of 22 children with RVH (68.2%), which is concordant with previously published series [1, 2, 3, 4]. Use of intravascular ultrasound and pressure monitoring guidewire may increase the accuracy of intervention. Further investigation is necessary to determine if the clinical success rate of PTRA in children can be improved with the use of these tools.