Percutaneous transluminal angioplasty for renovascular hypertension in a neonate

Abstract

Aim: To report on the first case of successful percutaneous transluminal renal artery angioplasty in a neonate.

Case report: a 5-d-old neonate was admitted with cardiorespiratory failure. Monitoring of blood pressure revealed severe arterial hypertension. Doppler sonography detected stenotic flow in the right renal artery. A (99m)Tc-MAG3 scan revealed highly diminished elimination by the right kidney. Selective renin levels were 23,968 ng/l in the right and 3770 ng/l in the left renal vein and the aorta. Percutaneous transluminal angioplasty using a 2 x 10 mm balloon catheter was performed on the 8th day of life.

Results: The patient was discharged from hospital normotensive without anti-hypertensive medication. During 8 mo follow-up the blood pressure remained normal, Doppler sonography revealed no recurrent artery stenosis, and renal function improved.

Conclusion: Neonatal percutaneous transluminal angioplasty for renal artery stenosis may be feasible in selected patients.