Journal of JCIC

We successfully performed percutaneous transluminal angioplasty (PTRA) to treat renovascular hypertension with renal atrophy in a one-year-old infant. He had a severe right renal artery stenosis, the narrowest diameter was 0.4 mm (the normal diameter proximal to the stenosis was 2.0 mm), associated with a right renal atrophy and dysfunction in the affected kidney. The renovascular hypertension was refractory to multiple antihypertensive drugs introduction. We performed PTRA using SHIDEN 2 mm/2 cm (KANEKA MEDIX, Osaka). The stenosis completely disappeared at seven months after PTRA. The blood pressure decreased gradually and have been maintained normal range without antihypertensive drugs at 14 months after PTRA. The improvement of the right renal atrophy and dysfunction was also identified, the size of the affected kidney was normalized at 31 months of follow-up. In children, PTRA has been reported less effective than in adults. Meanwhile, there was no previous report which described the efficacy of PTRA in infants who have severe stenosis associated with renal atrophy and dysfunction. This is the first report of morphological and functional reverse remodeling of the affected kidney, beside improvement of blood pressure, by PTRA.