Analysis of the efficacy and associated factors of percutaneous transluminal angioplasty for renal artery stenosis in children

doi:10.3877/cma.j.issn.2095-5782.2024.01.004

Abstract

Abstract:

Objective

To investigate the percutaneous transluminal angioplasty (PTA) Safety, efficacy, and clinical efficacy related factor analysis of renal vascular hypertension (RVH) caused by renal artery stenosis in children.

Methods

The clinical data from January 2017 to July 2023, a total of 31 cases were included, including 19 cases of Fibromuscular dysplasia(FMD) and 12 cases of Takayasu arteritis (TA). The treatment efficacy and related factors were evaluated by comparing the signs and blood pressure before and after surgery.

Results

A total of 48 PTA sessions were performed, and the follow-up time was from 0.5 to 6.6 years, among which 17 patients were cured, and 7 patients had improved symptoms.24 patients (77.4%) after percutaneous angioplasty, including 16 children with long-term benefit with FMD and 8 children with TA; the ineffective patients had high basal systolic pressure (155 mmHg vs 181 mmHg) and high proportion of vascular non-focal lesions (85.7% vs 16.7%); moreover, all ineffective patients with other symptoms (100%), and the differences were statistically significant. Both univariate and multivariate regression analysis found that focal renal artery lesions were a protective factor for the effect of PTA treatment, and the surgical response rate in patients with focal lesions was 30 times that in patients with non-focal lesions (OR = 30, P = 0.005).

Conclusion

Percutaneous transluminal angioplasty is safe and effective with good long-term follow-up. Patients with focal renal artery lesions had relatively good results after surgery.

Key words: Percutaneous transluminal angioplasty, Children, Hypertension, Renal artery stenosis, Efficacy

Ningdong Pang, Yizhou Jiang, Hua Jiang, Chuanqiang Niu, Haibo Li, Lang Liu, Zhenyin Liu, Jing Zhang. Analysis of the efficacy and associated factors of percutaneous transluminal angioplasty for renal artery stenosis in children[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2024, 12(01): 22-26.

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URL: https://zhjrfsxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-5782.2024.01.004

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References 15

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变量	无效组（7例）	有效组（24例）	F/χ²值	P值
年龄（岁，±s）	7.14±3.08	6.72±3.67	0.08	0.780
身高（cm，±s）	127.29±20.97	118.88±26.08	0.61	0.440
体质量[kg，M（Q₁，Q₃）]	27.00（18.50，28.30）	21.50（13.62，41.38）	0.22	0.640
疾病时长[d，M（Q₁，Q₃）]	60.00（30.00，120.00）	60.00（18.70，202.50）	0.62	0.440
收缩压[mmHg，M（Q₁，Q₃）]	180（175.00，185.00）	155（150.00，160.00）	85.30	< 0.010
性别[例（%）]			1.92	0.170
女性	5（71.40）	10（41.70）
男性	2（28.60）	14（58.30）
病变程度[例（%）]			11.82	0.001
单侧局灶	1（14.30）	20（83.30）
非局灶性	6（85.70）	4（16.70）
合并其他症状	7（100.00）	0（0.00）	31.00	<0.001

变量	无效组（7例）	有效组（24例）	F/χ²值	P值
年龄（岁，±s）	7.14±3.08	6.72±3.67	0.08	0.780
身高（cm，±s）	127.29±20.97	118.88±26.08	0.61	0.440
体质量[kg，M（Q₁，Q₃）]	27.00（18.50，28.30）	21.50（13.62，41.38）	0.22	0.640
疾病时长[d，M（Q₁，Q₃）]	60.00（30.00，120.00）	60.00（18.70，202.50）	0.62	0.440
收缩压[mmHg，M（Q₁，Q₃）]	180（175.00，185.00）	155（150.00，160.00）	85.30	< 0.010
性别[例（%）]			1.92	0.170
女性	5（71.40）	10（41.70）
男性	2（28.60）	14（58.30）
病变程度[例（%）]			11.82	0.001
单侧局灶	1（14.30）	20（83.30）
非局灶性	6（85.70）	4（16.70）
合并其他症状	7（100.00）	0（0.00）	31.00	<0.001

变量	OR	95%CI	P值
性别	3.500	0.562	0.180
		21.811
年龄	0.965	0.754	0.774
		1.234
身高	0.985	0.949	0.431
		1.023
体质量	1.015	0.954	0.628
		1.081
病变程度	30.000	2.794	0.005
		322.09
疾病时长	1.002	0.996	0.496
		1.009
收缩压	0.002	-	0.993

变量	OR	95%CI	P值
性别	3.500	0.562	0.180
		21.811
年龄	0.965	0.754	0.774
		1.234
身高	0.985	0.949	0.431
		1.023
体质量	1.015	0.954	0.628
		1.081
病变程度	30.000	2.794	0.005
		322.09
疾病时长	1.002	0.996	0.496
		1.009
收缩压	0.002	-	0.993

变量	OR	95%CI	P值
病变程度	30.000	2.794	0.005
		322.090

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