Skip to main content
SpringerLink
Log in

Renal artery stenting in a 2-year-old child with resistant hypertension and neurofibromatosis

  • Case Report
  • Published:
Cardiovascular Intervention and Therapeutics Aims and scope Submit manuscript

Abstract

The occurrence of vascular lesions in neurofibromatosis is uncommon but well documented. These vascular lesions when present, occur predominantly in the kidneys, endocrine glands, heart and gastrointestinal tract, causing stenosis or obliteration of the lumen. We report a case of uncontrolled resistant hypertension in a 2-year-old child presenting with neurofibromatosis who was found to have a high-grade ostial left renal artery stenosis and obliteration of the right renal artery. As the right kidney was small and hypo-functioning, and its renal artery was totally occluded, we subjected the child to a left renal angioplasty and bailout stenting. Following stenting, the blood pressure decreased with anti-hypertensive treatment. Based on a review of the literature, and to the best of our knowledge, this is the youngest child to have undergone renal artery stenting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Halpern M, Currarino G. Vascular lesions causing hypertension in neurofibromatosis. N Engl J Med. 1965;273:248–52.

    Article  Google Scholar 

  2. Booth C, Preston R, Clark G, Reidy J. Management of renal vascular disease in neurofibromatosis type 1 and the role of percutaneous transluminal angioplasty. Nephrol Dial Transplant. 2002;17:1235–40.

    Article  PubMed  Google Scholar 

  3. Schurch W, Messerli FH, Lefebvre R, Roy P, Cartier P. Arterial hypertension and neurofibromatosis. Can Med Assoc J. 1975;113:879–85.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Cornell S, Kirkendall W. Neurofibromatosis of the renal artery. Radiology. 1967;88:24–8.

    Article  CAS  PubMed  Google Scholar 

  5. Fossali E, Minoja M, Intermite R, Spreafico C, Casalini E, Sereni F. Percutaneous transluminal renal angioplasty in neurofibromatosis. Pediatr Nephrol. 1995;9:623–5.

    Article  CAS  PubMed  Google Scholar 

  6. Fossali E, Signorini E, Intermite RC, Casalini E, Lovaria A, Maninetti MM, Rossi LN. Renovascular disease and hypertension in children with neurofibromatosis. Pediatr Nephrol. 2000;14:806–10.

    Article  CAS  PubMed  Google Scholar 

  7. Mallmann R, Roth FJ. Treatment of neurofibromatosis associated renal artery stenosis with hypertension by percutaneous transluminal angioplasty. Clin Exp Hypertens. 1986;8:893–9.

    CAS  Google Scholar 

  8. Grüntzig A, Kuhlmann U, Vetter W, Lütolf U, Meier B, Siegenthaler W. Treatment of renovascular hypertension with percutaneous transluminal dilatation of a renal-artery stenosis. Lancet. 1978;1(8068):801–2.

    Article  PubMed  Google Scholar 

  9. Ing Frank F, Goldberg B, Siegel DH, Trachtman H, BiermanF Z. Arterial stents in the management of neurofibromatosis and renovascular hypertension in a pediatric patient: case report of a new treatment modality. Cardiovasc Interv Radiol. 1995;18:414–8.

    Article  CAS  Google Scholar 

  10. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl 4th Report):555.

    Article  Google Scholar 

  11. Colyer JH, Ratnayaka K, Slack MC, Kanter JP. Renal artery stenosis in children: therapeutic percutaneous balloon and stent angioplasty. Pediatr Nephrol. 2014;29:1067–74.

    Article  PubMed  Google Scholar 

  12. Schillinger M, Minar E. Percutaneous treatment of peripheral artery disease: novel techniques. Circulation. 2012;126:2433–40.

    Article  PubMed  Google Scholar 

  13. Stone PA, Campbell JE, Aburahma AF, Hamdan M, Broce M, Nanjundappa A, Bates MC. Ten year experience with renal artery in-stent restenosis. J Vasc Surg. 2011;53:1026–31.

    Article  PubMed  Google Scholar 

  14. Abate MT, Kaur J, Suh H, Darras F, Mani A, Nord EP. The use of drug-eluting stents in the management of transplant renal artery stenosis. Am J Transplant. 2011;11:2235–41.

    Article  CAS  PubMed  Google Scholar 

  15. Brountzos EN, Ptohis N, Triantafyllidi H, Panagiotou I, Spyridopoulos TN, Misiakos EP, Kelekis A. Renal artery rupture following cutting balloon angioplasty for fibromuscular dysplasia: a case report. Cases J. 2009;2:888.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, St. John’s Medical College Hospital, Bangalore, 560034, India

    Kiron Varghese, Srilakshmi M. Adhyapak & S. B. Lohitashwa

  2. Department of Pediatric Nephrology, St. John’s Medical College Hospital, Bangalore, India

    Priya Pais & Arpana A. Iyengar

Authors
  1. Kiron Varghese
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Srilakshmi M. Adhyapak
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. B. Lohitashwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Priya Pais
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Arpana A. Iyengar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Srilakshmi M. Adhyapak.

Ethics declarations

Conflict of interest

None of the authors have any conflict of interest to declare.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Varghese, K., Adhyapak, S.M., Lohitashwa, S.B. et al. Renal artery stenting in a 2-year-old child with resistant hypertension and neurofibromatosis. Cardiovasc Interv and Ther 32, 274–278 (2017). https://doi.org/10.1007/s12928-016-0415-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12928-016-0415-z

Keywords

Search

Navigation