Segmental renal artery embolization for treatment of pediatric renovascular hypertension.

Selective intrarenal arterial embolization was used to treat three children with documented renovascular hypertension. Embolization resulted in complete cure (ie, elimination of all antihypertensive medicines) in all three patients and caused only minimal loss of renal parenchyma. Renal vein renin sampling, including sampling after furosemide administration, correlated well with the location of identified vascular lesions and helped direct selective angiography when lesions were not found initially. Intrarenal arterial embolization is a safe, effective alternative to surgical resection in the treatment of renovascular hypertension in children who have identifiable intrarenal arterial lesions not amenable to balloon angioplasty.