Renal artery coil embolization of a non-functional kidney: A novel method to treat resistant hypertension in paediatric patients

Hypertension in children is often secondary to underlying renal disease and is difficult to manage with anti-hypertensive medications without intervention. We report a case of resistant hypertension in a child aged 4 years with non-functioning right kidney who was successfully treated with renal artery coil embolization (RAE), as he was high risk for surgical nephrectomy owing to the presence of severe left ventricular dysfunction. In our case the right renal artery had an acute angle with the aorta, hence we used Simmons catheter which is very useful in such cases. This percutaneous intervention enabled immediate and sustained blood pressure control which was maintained at 6 months of follow up. Coil embolization of non-functional kidney for refractory hypertension as a bail out procedure in high surgical risk paediatric patients has never been reported previously in paediatric age group and is an acceptable percutaneous strategy.