Document Detail


Diagnosis and management of stenotic aorto-arteriopathy in childhood.
MedLine Citation:
PMID:  9627596     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Stenotic aorto-arteriopathy is an uncommon vascular lesion characterized by segmental arterial stenoses. We reviewed the experience with several management algorithms to define the most effective management course. The clinical records of 14 pediatric patients with acquired SAA who presented over a 16-year period were reviewed. Most patients presented with a mid-thoracoabdominal coarctation and were diagnosed with Takayasu arteritis. Differentiating between Takayasu arteritis and fibromuscular dysplasia was difficult on clinical grounds or by angiography. Medical management of the end-organ disease and renovascular hypertension was only palliative. Selective percutaneous transluminal balloon angioplasty of the stenotic renal arteries had only transient benefits; renal autotransplantation had slightly better success. Dilation of stenosed aortic segments with balloon-expandable endovascular stents and subsequent renal autotransplantation proved useful. Distinguishing SAA resulting from fibromuscular dysplasia caused by Takayasu arteritis in the chronic vaso-occlusive phase may be unnecessary for effective treatment. Therapy should focus on interventions to minimize the end-organ damage caused by the vaso-occlusive manifestations of the disorders.
Authors:
S J D'Souza; W S Tsai; M M Silver; P Chait; L N Benson; E Silverman; D Hebért; J W Balfe
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  132     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-07-01     Completed Date:  1998-07-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1016-22     Citation Subset:  AIM; IM    
Affiliation:
Hospital for Sick Children, Department of Pediatrics, Division of Nephrology, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Algorithms
Angioplasty, Balloon
Aorta, Abdominal
Aorta, Thoracic
Aortic Coarctation / diagnosis,  therapy
Aortic Diseases / diagnosis*,  therapy*
Aortography
Child
Child, Preschool
Diagnosis, Differential
Female
Fibromuscular Dysplasia / diagnosis*,  therapy*
Humans
Male
Retrospective Studies
Stents
Takayasu Arteritis / diagnosis*,  therapy*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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