Zusammenfassung
Eine arterielle Hypertonie im Kindesalter hat in etwa 1/3 der Fälle eine renovaskuläre Ursache [36]. Differenzialdiagnostisch müssen eine Nierenarterienstenose und eine Bauchaortenstenose unterschieden werden. Die Synonyme abdominelle Koarktation (CoA abd.), Bauchaortenstenose und Mid-Aortic-Syndrom (MAS) definieren eine Einengung der Aorta und ihrer äste unterhalb des Zwerchfells. Diese führt, ähnlich wie die Aortenisthmusstenose oder die thorakale Aortenstenose, zu einer Erhöhung des Blutdrucks in der oberen Körperhälfte und zu einer Minderperfusion distal der Stenose. In etwa 80–90% der Fälle sind auch die Nierenarterien betroffen [29]. Die Minderperfusion der Nieren führt zu einer Stimulation der Reninausschüttung, die die wesentliche Ursache für die Blutdruckerhöhung darstellt. In Abhängigkeit davon, ob eine oder beide Nieren von einer Perfusionsminderung betroffen sind, entstehen in Anlehnung an die Goldblatt- Modelle entweder eine renin- oder eine volumenabhängige Hypertonie [12, 23].
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
Literatur
Adelman RD, Morrell RE (2000) Coarctation of the abdominal aorta and renal artery stenosis related to an umbilical artery catheter placement in a neonate. Pediatrics 106:E36
Ashida A, Matsumura H, Inoue N et al (2006) Two cases of hyponatremic-hypertensive syndrome in childhood with renovascular hypertension. Eur J Pediatr 165:336–339
Brun P, Kchouk H, Mouchet B et al (1997) Value of Doppler ultrasound for the diagnosis of renal artery stenosis in children. Pediatr Nephrol 11:27–30
Brzezinska-Rajszys G, Qureshi SA, Ksiazyk J et al (1999) Middle aortic syndrome treated by stent implantation. Heart 81:166–170
Calhoun TR, Thumwood RG, Tennyson KB, Wright RM, Kitten CM, Windham PA (1983) Coarctationn of the abdominal aorta. Tex Heart Inst J 10:269–273
Criado E, Izquierdo L, Lujan S, Puras E, del Mar EM (2002) Abdominal aortic coarctation, renovascular, hypertension, and neurofibromatosis. Ann Vasc Surg 16:363–367
DeBakey ME, Garrett HE, Howell JF (1967) Coarctation of the abdominal aorta with renal arterial stenosis. Ann Surg 1967:830–843
Dejardin A, Goffette P, Moulin P et al (2004) Severe hypoplasia of the abdominal aorta and its branches in a patient and his daughter. J Intern Med 255:130–136
Delis KT, Gloviczki P (2005) Middle aortic syndrome: from presentation to contemporary open surgical and endovascular treatment. Perspect Vasc Surg Endovasc Ther 17:187–203
Doerr W (1960) Pathologische Anatomie der angeborenen Herzfehler. In: Bergmann G von, Frey W, Schwiegk H (Hrsg) Handbuch der Inneren Medizin, 4. Aufl. Springer, Berlin Heidelberg New York
Flynn PM, Robinson MB, Stapleton FB, Roy S III, Koh G, Tonkin IL (1984) Coarctation of the aorta and renal artery stenosis in tuberous sclerosis. Pediatr Radiol 14:337–339
Goldblatt H (1934) Studies on experimental hypertension I. The production of persistent elevation of systolic blood pressure by means of renal ischemia. J Exp Med 59:347
Graham LM, Zelenock GB, Erlanson EE (1979) Abdominal aortic coarctation and segmental hypoplasia. Surgery 86:519–529
Hallett JW, Brewster DC, Darling RC (1980) Coarctation of the abdominal aorta: current options in surgical management. Ann Surg 191:430–437
Hiner LB, Falkner B (1993) Renovascular hypertension in children. Pediatr Clin North Am 40:123–140
Honjo O, Ishino K, Kawada M, Ohtsuki S, Sano S (2005) Coarctation of the thoracoabdominal aorta associated with mucopolysaccharidosis VII in a child. Ann Thorac Surg 80:729–731
Hope-Ross P, Bien EJ, Palladino VS, Graham G (1960) Rheumatoid aortitis: report of an unusual case. Ann Intern Med 52:682–688
König K, Gellermann J, Querfeld U, Schneider MB (2006) Treatment of severe renal artery stenosis by percutaneous transluminal renal angioplasty and stent implantation: review of the pediatric experience: apropos of two cases. Pediatr Nephrol 21:663–671
Krovertz LJ, Lorincz AE, Schiebler GL (1965) Cardiovascular manifestation of the Hurler syndrome. Circulation 31:132–141
Krumme B, Blum U, Schwertfeger E et al (1996) Diagnosis of renovascular disease by intra-and extrarenal Doppler scanning. Kidney Int 50:1288–1292
Lacombe M (1999) [Surgical treatment of renal artery lesions in children]. Chirurgie 124:264–271
Lander H, Bonnin JM (1956) Giant cell arteriitis: report of a case with autopsy. L Bacterial Pathol 71:369–373
Laragh JH (1977) The renin system in essential, renovascular and adrenocortical hypertension: an overview. Adv Nephrol Necker Hosp 7:157–189
Martinez A, Novick AC, Cunningham R, Goormastic M (1990) Improved results of vascular reconstruction in pediatric and young adult patients with renovascular hypertension. J Urol 144:717–720
Maycock W (1937) Congenital stenosis of the abdominal aorta. Am Heart J 13:633–637
Messina LM, Goldstone J, Ferell LD (1986) Middle aortic syndrome: effectiveness and durability of complex arterial revasculation techniques. Ann Surg 204:331–339
Moresco KP, Shapiro RS (1995) Abdominal aortic coarctation: CT, MRI, and angiographic correlation. Comput Med Imaging Graph 19:427–430
Murat A, Akarsu S, Ozdemir H, Yildirim H, Kalender O (2005) Renal resistive index in healthy children. Eur J Radiol 53:67–71
Panayiotopoulos YP, Koffman TG, Reidy JF, Haycock GB, Taylor PR (1996) Mid-aortic syndrome presenting in childhood. Br J Surg 83:235–240
Radermacher J, Chavan A, Schaffer J et al (2000) Detection of significant renal artery stenosis with color Doppler sonography: combining extrarenal and intrarenal approaches to minimize technical failure. Clin Nephrol 53:333–343
Reiher L, Sandmann W (1998) Die Coarctatio der thoracoabdominalen Aorta. Chirurg 69:753–758
Scott HW, Dean RH, Boerth R, Sawyers JL (1979) Coarctation of the abdominal aorta. Ann Surg 189:746–751
Shefler AG, Chan MK, Ostman-Smith I (1997) Middle aortic syndrome in a boy with arteriohepatic dysplasia (Alagille syndrome). Pediatr Cardiol 18:232–234
Sigirci A, Hallac T, Akyncy A et al (2006) Renal interlobar artery parameters with duplex Doppler sonography and correlations with age, plasma renin, and aldosterone levels in healthy children. Am J Roentgenol 186:828–832
Stadlmaier E, Spary A, Tillich M, Pilger E (2005) Midaortic syndrome and celiac disease: a case of local vasculitis. Clin Rheumatol 24:301–304
Stanley JC, Zelenock GB, Messina LM (1995) Pediatric renovascular hypertension: a thirty year experience of operative treatment. J Vasc Surg 21:212–226
Stanley JC, Criado E, Upchurch GR et al (2006) Pediatric renovascular hypertension: 132 primary and 30 secondary operations in 97 children. J Vasc Surg 44:1219–1228
Stiller B, Weng Y, Berger F (2006) Images in cardiology. Mid aortic syndrome: a rare cause of reversible cardiomyopathy. Heart 92:640
Taketani T, Miyata T, Morota T, Takamoto S (2005) Surgical treatment of atypical aortic coarctation complicating Takayasu’s arteritis — experience with 33 cases over 44 years. J Vasc Surg 41:597–601
Terramani TT, Salim A, Hood DB, Rowe VL, Weaver FA (2002) Hypoplasia of the descending thoracic and abdominal aorta: a report of two cases and review of the literature. J Vasc Surg 36:844–848
Vo NJ, Hammelman BD, Racadio JM, Strife CF, Johnson ND (2006) Anatomic distribution of renal artery stenosis in children: implications for imaging. Pediatr Radiol 36:1032–1036
Voiculescu A, Hofer M, Hetzel GR et al (2001) Noninvasive investigation for renal artery stenosis: contrast-enhanced magnetic resonance angiography and color Doppler sonography as compared to digital subtraction angiography. Clin Exp Hypertens 23:521–531
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Heusch, A., Voiculescu, A. (2010). Abdominelle Koarktation und Nierenarterienstenose im Kindesalter. In: Pourhassan, S., Sandmann, W. (eds) Gefäßerkrankungen im Kindes- und Jugendalter. Steinkopff. https://doi.org/10.1007/978-3-7985-1760-8_16
Download citation
DOI: https://doi.org/10.1007/978-3-7985-1760-8_16
Publisher Name: Steinkopff
Print ISBN: 978-3-7985-1759-2
Online ISBN: 978-3-7985-1760-8
eBook Packages: Medicine (German Language)