PERCUTANEOUS TRANSLUMINAL RENAL ANGIOPLASTY IN NEUROFIBROMATOSIS

A 9-year-old boy with hypertension was found to have neurofibromatosis associated with stenosis of the right renal artery. Percutaneous tran sluminal angioplasty (PTA) was performed. Immediately post angioplasty angiography showed that the stenosis persisted, but over the next few days his blood pressure rapidly decreased and remained well controlle d even when treatment was discontinued. The captopril stimulation test , performed after PTA, confirmed the return of plasma renin activity t o normal values. A digital subtraction aortogram, performed 2.5 years after PTA, was unchanged. His blood pressure remained persistently nor mal, without anti-hypertensive agents. Based on these results, PTA is suggested as the first step in correcting renal artery stenosis due to neurofibromatosis. A complete anatomical resolution of the stenosis i s probably not required since slight improvements in the renal artery lumen may be accompanied by important functional improvement.