Dilation of the Renal Artery in an Infant: 5 Years Later

Abstract

A 5-month-old infant with a solitary pelvic kidney presented with severe cardiorespiratory distress and hypertension (220/ 160 mm Hg) that was unresponsive to four antihypertensive medications. A critical ostial renal artery stenosis (near the aortic bifurcation) was treated via the left axillary artery with 3-mm and later 4-mm diameter balloon angioplasty (Figures 1 and 2, arrows). Antihypertensive therapy was gradually tapered nd finally completely stopped by 12 months after dilation. At age 5.5 years, the child is normotensive, is free of medications, and has normal renal function. Follow-up angiography, performed because of anomalous drainage from the portal vein into the lower caval vein (Abernethy malformation), showed no stenosis of the renal artery and good flow into the solitary kidney (Figure 3, arrow).