• Alexandre Mota Imaging Department, Centro Hospitalar Tondela-Viseu
  • Paulo Donato Imaging Department, Centro Hospitalar Universitário de Coimbra
  • Maria José Noruegas Imaging Department, Centro Hospitalar Universitário de Coimbra
  • Vítor Carvalheiro Imaging Department, Centro Hospitalar Universitário de Coimbra
  • Ângela Moreira Imaging Department, Centro Hospitalar Universitário de Coimbra



Hypertension, renovascular, Percutaneous transluminal angioplasty, ultrasonography, Doppler


We report a clinical case of renovascular disease, probably linked to fibromuscular dysplasia, in a 12 months old boy with severe arterial hypertension with target-organ damage, highlighting the radiological approach.

Initial investigation included renal ultrasound that showed normal sized kidneys, with normal cortical echogenicity on the right and focally increased echogenicity of the posterior aspect of the left kidney, forming a mass-like lesion. Magnetic resonance imaging excluded renal tumor, which was confirmed by ultrasound guided biopsy. A doppler ultrasonography was also performed suggesting a right renal artery stenosis and decreased flow to the posterior aspect of the left kidney. Angiography with diagnostic and therapeutic intention was performed: right renal artery stenosis was detected and transluminal ballon dilation was performed; the left renal artery bifurcated precociously and the branch that irrigated the posterior part of the kidney had a stenosis which was also successfully dilated. After the intervention good blood pressure control with antihypertensive drugs was achieved, which was not possible before the angiographic procedure.

The authors underline various methods of imaging used to accurately diagnose renovascular disease and the usefulness of interventional radiology treatment for this disease in very young children.


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Srinivasan A, Krishnamurthy G, Fontalvo-Herazo L, Nijs E,Keller MS, Meyers K, Kaplan B et al. Angioplasty for renalartery stenosis in pediatric patients: an 11-year retrospectiveexperience. J Vasc Interv Radiol. 2010;21: 1672-80.

Giavroglou C, Tsifountoudis I, Boutzetis T, Kiskinis D. Failureand success of percutaneous angioplasty in a hypertensivechild with bilateral renal artery stenosis. C CardiovascIntervent Radiol. 2009;32: 150-4.

Marks SD, Tullus K.. Update on imaging for suspectedrenovascular hypertension in children and adolescents. CurrHypertens Rep. 2012;14: 591-5.

Tullus K, Roebuck DJ, McLaren CA, Marks SD. Imaging inthe evaluation of renovascular disease. Pediatr Nephrol.2010;25: 1049-56.

Slovut DP, Olin JW. Fibromuscular dysplasia. N Engl J Med.2004; 350: 1862–71.

Burnei G, Burnei A, Hodorogea D, Gavriliu S, Georgescu I,Vlad C et al. Reno-ureteral diseases inducing hypertensionin children. Rom J Intern Med. 2008;46: 367-74.

Chhadia S, Cohn RA, Vural G, Donaldson JS. Renal Dopplerevaluation in the child with hypertension: a reasonablescreening discriminator? Pediatr Radiol. 2013;43: 1549-56.

Zhu G, He F, Gu Y, Yu H, Chen B, Hu Z et al. Angioplasty forpediatric renovascular hypertension: a 13-year experience.Diagn Interv Radiol. 2014;20: 285-92.

Alfonzo JP, Ugarte C, Banasco J, Fraxedas R, GutiérrezF, Lahera J. Renovascular hypertension in children andadolescents: diagnosis and treatment over 19 years.Nefrologia. 2006;26: 573-80.

Dworkin LD, Cooper CJ. Clinical practice. Renal-arterystenosis. N Engl J Med. 2009:12;361: 1972-8.

Alhadad A, Mattiasson I, Ivancev K, Gottsäter A, LindbladB.Revascularisation of renal artery stenosis caused byfibromuscular dysplasia: effects on blood pressure during7-year follow-up are influenced by duration of hypertensionand branch artery stenosis. J Hum Hypertens. 2005;19: 761-7.

Kari JA, Roebuck DJ, McLaren CA, Davis M, Dillon MJ,Hamilton G et al. Angioplasty for renovascular hypertensionin 78 children. Arch Dis Child. 2015;100: 474-8.

Niimura F, Matsuda S, Okamoto S, Suganuma E, Takakura H, Sugiyama Y et al. Renovascular hypertension due to bilateralrenal artery stenosis treated with stent implantation in a 12-year old girl. Tokai J Exp Clin Med. 2008:20;33: 78-83.

Geavlete O, Călin C, Croitoru M, Lupescu I, Ginghină C.Fibromuscular dysplasia-a rare cause of renovascularhypertension. Case study and overview of the literature data.J Med Life. 2012:15;5: 316-20.




How to Cite

Mota A, Donato P, Noruegas MJ, Carvalheiro V, Moreira Ângela. RENOVASCULAR HYPERTENSION IN A 12 MONTH OLD BOY: WHAT CAN THE RADIOLOGIST DO?. REVNEC [Internet]. 2016Jun.21 [cited 2024May29];25(2):99-103. Available from:



Case Reports