SURGICAL TREATMENT OF VASORENAL HYPERTENSION IN CHILDREN
- Authors: Razumovsky A.Y.1, Alkhasov A.B.1, Bataev S.M.1, Abdurazakov M.A.1
-
Affiliations:
- Pirogov Russian National Research Medical University
- Issue: Vol 8, No 1 (2018)
- Pages: 36-43
- Section: Original Study Articles
- Submitted: 29.04.2018
- Accepted: 29.04.2018
- Published: 02.03.2018
- URL: https://rps-journal.ru/jour/article/view/397
- DOI: https://doi.org/10.17816/psaic397
- ID: 397
Cite item
Full Text
Abstract
Purpose. To estimate the results of surgical treatment of children with vasorenal hypertension.
Materials and methods. 11 patients with renovascular hypertension were operated from 1999 to 2015 with 9 boys and 2 girls among them. Their age varied from 5 months to 14 years old. Their weight was 4.6 kg to 40 kg. All children had high blood pressure values (130/80 to 250/120 mmHg) in spite of antihypertension drug therapy given.
Results. 10 patients had plasty of renal arteries affected both unilaterally (6) and bilaterally (4). An internal iliac artery was taken as a transplant in 10 cases whereas the great saphenous iliac vein was used in 2 cases. 1 child had undergone reimplantation of the renal artery. One patient in the group had the middle aortic syndrome (MAS) and pronounced hyperplasia of the renal arteries. Only abdominal aortic repair was performed in this case. In all cases a positive result was noted in the form of normalization of arterial blood pressure values until the complete withdrawal of antihypertensive agents (in 7 cases) or significant dosage reduction (4 patients).
Conclusions. Surgery is the basic method in the treatment of children with renovascular hypertension. Using the internal ileac artery as a transplant is accompanied with good early and remote postoperation results. The internal ileac artery and great saphenous vein can be used in a bilateral lesion.
About the authors
A. Y. Razumovsky
Pirogov Russian National Research Medical University
Author for correspondence.
Email: 1595105@mail.ru
Doctor of Medical Sciences, professor. Academician of the Academy of Sciences of the Russian Federation,
Moscow, Russia, 117997, Ostrovitanova st., 1
РоссияA. B. Alkhasov
Pirogov Russian National Research Medical University
Email: 7111957@mail.ru
Doctor of Medical Sciences, professor,
Moscow, Russia,117997, Ostrovitanova st., 1
РоссияS. M. Bataev
Pirogov Russian National Research Medical University
Email: khassan-2@yandex.ru
Dr.Sci (med), head of Department of the thoracic and abdominal surgery,
Moscow, 123317, Shmitovskiy proezd, 29
РоссияM. A. Abdurazakov
Pirogov Russian National Research Medical University
Email: walk_man7@mail.ru
Resident of the Department of the Children’s Surgery,
Moscow, Russia, Ostrovitanova st., 1
РоссияReferences
- Wyszynska T., Cichocka E., Wieteska-Klimczak A., Jobs K., Januszewicz P. A single pediatric center experience with 1025 children with hypertension. Acta Paediatr 1992; 81: 244–46.
- Tullus K., Brennan E., Hamilton G., Lord R., McLaren C. A., MarksS.D., Roebuck D. J. Renovascular hypertension in children. Lancet 2008; 371: 1453–63.
- Белов Ю. В., Степаненко А. Б., Косенков А. Н. Хирургия вазоренальной гипертензии. М.: МИА, 2007.
- Разумовский А. Ю., Ханвердиев Н. А. Стеноз почечных артерий у детей: диагностика и хирургические методы лечения // Детская хирургия. 2009; №4: 40–44.
- Humbert J., Roussey-Kesler G., Guerin P., LeFrançois T., Connault J., Chenouard A. Diagnostic and medical strategy for renovascular hypertension: report from a monocentric pediatric cohort. Eur J Pediatr 2015; 174 (1):23–32. DOI: 10.1007/ s00431 014 2355 x.
- Shroff R., Roebuck D. J., Gordon I., Davies R., Stephens S., Marks S. et al. Angioplasty for renovascular hypertension in children: 20 year experience. Pediatrics 2006; 118: 268–275.
- Stanley J. C., Criado E., Upchurch G. R., Brophy P. D., Cho K. J., Rectenwald J. E. et al. Pediatric renovascular hypertension: 132 primary and 30 secondary operations in 97 children. J. Vasc. Surg. 2006; 44 (6):1219–29. doi: 10.1016/j.jvs.2006.08.009.
- McLaren C. A., Roebuck D. J. Interventional radiology for renovascular hypertension in children. Tech VascIntervRadiol. 2003; 6:150–57.
- Stanley J. S., Ernst C. B., Fry W. J. Fate of 100 aortorenal vein grafts: characteristics of late graft expansion, aneurismal dilatation, and stenosis. Surgery. 1973; 74: 931–944.
- Sandmann W., Dueppers P., Pourhassan S., Voiculescu A., Klee D., Balzer K. M. Early and long-term results after reconstructive surgery in 42 children and two young adults with renovascular hypertension due to fibromuscular dysplasia and middle aortic syndrome. Eur J VascEndovasc Surg. 2014; 47 (5):509–16. doi: 10.1016/j.ejvs.2013.12.012.
- Stadermann M. B., Montini G., Hamilton G., Roebuck D. J., McLaren C. A., Dillon M. J. et al. Results of surgical treatment for renovascular hypertension in children: 30 year single-centre experience. Nephrol Dial Transplant. 2010; 25 (3):807– 813. doi: 10.1093/ndt/gfp537.
- Lacombe M. Surgical treatment of renovascular hypertension in children. Eur J VascEndovascSurg. 2011;41:770–7. doi: 10.1016/j.ejvs.2011.02.023.
- Kimura H., Sato O., Deguchi J. O., Miyata T. Surgical treatment and long-term outcome of renovascular hypertension in children and adolescents. Eur J VascEndovasc Surg. 2010;39 (6):731–737. doi: 10.1016/j.ejvs.2010.03.019.