Renovascular Hypertension in the Pediatric Patient

William J. Fry, MD; Calvin B. Ernst, MD; James C. Stanley, MD; Bruce Brink, MD
Arch Surg. 1973;107(5):692-698. doi:10.1001/archsurg.1973.01350230048010.
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Twenty-two children (22 months to 17 years old) were operated upon for renovascular hypertension, 20 by angioplastic reconstruction, and two (very early in the series) by nephrectomy. Their main symptoms were hyperexcitability, headaches, or convulsions. Fibromuscular dysplasia caused the narrowing in 20 patients. In 15 of the 22 patients, the lesions were in the main renal artery, in seven in the segmental branches. Four patients suffered associated neurofibromatosis. Only in them was the dysplasia at the ostium of the main renal artery. The most common operative technique was saphenous vein bypass graft. Dilation was used for multiple segmental artery involvements. After a one- to nine-year follow-up, 19 patients are cured. We consider that there is now no place for nephrectomy or medical therapy as primary modes of therapy in this condition.


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