1251 PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY FOR RENOVASCULAR HYPERTENSION IN CHILDREN
Bibliographic record
Abstract
You have accessJournal of UrologyPediatrics: Imaging Genital & Urinary Tract/Infections and Vesicoureteral Reflux/Andrology - Cryptorchidism & Varicoceles1 Apr 20101251 PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY FOR RENOVASCULAR HYPERTENSION IN CHILDREN Angus Alexander, Kristin Kozakowski, Armando Lorenzo, Walid Farhat, Darius Bagli, Pippi Salle, Lara Richmond, and Biarbre Connolly Angus AlexanderAngus Alexander More articles by this author , Kristin KozakowskiKristin Kozakowski More articles by this author , Armando LorenzoArmando Lorenzo More articles by this author , Walid FarhatWalid Farhat More articles by this author , Darius BagliDarius Bagli More articles by this author , Pippi SallePippi Salle More articles by this author , Lara RichmondLara Richmond More articles by this author , and Biarbre ConnollyBiarbre Connolly More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.796AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Renal vascular stenosis causes 3-8.5% of pediatric hypertension. Endo-luminal interventions are gaining traction in the pediatric arena as equipment, experience and skills improve. By analyzing our experience, we hope to add to the published data on the safety and efficacy of percutaneous transluminal angioplasty (PTA) for renovascular hypertension in children. METHODS We performed a retrospective analysis of all patients that underwent renal PTA at a single centre between April 1992 and December 2008. Data capture was focused on clinical outcomes and complications. Cure is defined as a normalization of blood pressure (BP) without the need for antihypertensives. Improved defines a decrease in the number or dose of antihypertensive required to control BP or a normalization of BP on the same dose of antihypertensives. Failure defines no discernable difference in BP control. RESULTS Thirty-one pediatric patients underwent renal, percutaneous transluminal angioplasty (PTA). Forty-two angiograms were performed in total. Five patients were lost to follow up. Of the remaining 26 patients (37 PTA's), the median age at intervention was 8 years with a range of 6months-17 years. Fifty-seven percent were male. Four patients had 2 PTA's, 2 patients had 3 PTA's and 1 patient had 4 PTA's. Six (23%) stenoses were bilateral, 10 (38%) occurred on the right, 8 (31%) occurred on the left and 2 were in transplanted kidneys. Forty-two percent of lesions involved the renal artery trunk, while 30% were ostial lesions. Seven patients had associated systemic or regional vasculopathy. After at least 1 year of follow up, cure was achieved after 8 angioplasties (21%), improvement in BP control was achieved after 9 (24%) and failure was evident in 20 angioplasties (54%). Major complications included a hypoglycemic seizure, 1 renal unit loss and an ischemic limb. Minor complications included 4 burst balloons, 3 groin hematomas and 1 prolonged admission for bleeding that did not require transfusion. CONCLUSIONS Renal angioplasty is relatively safe and effective in the pediatric patient. In our series it was beneficial in 46% and failed in 54%. While surgical series quote much higher rates of cure (70-98%), PTA is less invasive and appears to be a safe and worthwhile first step in the management of pediatric renovascular hypertension. Toronto, Canada© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e484 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Angus Alexander More articles by this author Kristin Kozakowski More articles by this author Armando Lorenzo More articles by this author Walid Farhat More articles by this author Darius Bagli More articles by this author Pippi Salle More articles by this author Lara Richmond More articles by this author Biarbre Connolly More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".