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For Kids With High BP, Surgery Can Help When Medicines Fail

ertension will respond positively, and 70 percent will be cured completely. In the hands of the right team, the researchers say, children can survive the arduous operation and go on to have a normal life.

“This is a rare condition, but one that can be catastrophic if it’s not found and treated appropriately,” says lead author James C. Stanley, M.D., a U-M vascular surgeon who has operated on dozens of children with the condition in the past 40 years. “But the good news is that it is highly treatable with the help of an experienced diagnostic, surgical, and medical team.”

Stanley, the Handleman Research Professor of Vascular Surgery at U-M and a director of the U-M Cardiovascular Center, co-authored the report with U-M pediatric kidney specialists, interventional radiologists and vascular surgeons who make up the Michigan Pediatric Renovascular Group. Together, they treat children at the clinics, operating rooms and intensive care unit of the C.S. Mott Children’s Hospital, as well as U-M Cardiovascular Center diagnostic facilities.

The 97 children analyzed for the study had a total of 162 operations at U-M in the last 43 years. It is the world’s largest study of the condition to date. The patients in the study came to U-M from all over the national and the world, referred by their own doctors after multiple medications failed to help.

Stanley and his colleagues use advanced imaging techniques to diagnose the condition, and to guide the surgeons who use deft surgical techniques to reconstruct the narrowed blood vessels which are often only a few millimeters wide. Both minimally invasive angiography techniques, and non-invasive MRI and CT imaging, can be used to assess the condition.

In the paper, the U-M team describes in detail the surgical approach that yielded such high success rates for their patients. Because children are still growing, they cannot be treated using the artificial graft devices and stents that
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