Background Mesenchymal stem cell (MSC)-derived endothelial-like cells exhibit enhanced angiogenic potential compared with undifferentiated MSCs. However, the role of N6-methyladenosine (m6A) RNA modification in MSC endothelial differentiation remains unclear. Methods Human bone marrow-derived MSCs were isolated and induced toward an endothelial phenotype using cytokine-enriched medium. Endothelial differentiation was evaluated using flow cytometry, western blotting, immunofluorescence staining, tube formation assays, and Dil-Ac-LDL uptake assays. MeRIP-seq and RNA-seq were performed to profile transcriptome-wide m6A methylation and gene expression changes. Bioinformatics analyses, including GO enrichment, KEGG pathway analysis, and protein–protein interaction (PPI) network construction, were conducted to identify key regulatory genes and pathways. Results Following induction, MSCs exhibited endothelial characteristics, including increased expression of CD31 and CD34, enhanced tube formation ability, and increased Dil-Ac-LDL uptake. Transcriptome-wide analysis identified 16,355 differentially methylated peaks and 2,732 differentially expressed genes, including 1,204 differentially methylated and expressed genes (DMEGs). Functional enrichment analysis revealed that DMEGs were mainly associated with extracellular matrix organization, endothelial differentiation, and cell adhesion. PPI network analysis identified a highly interconnected module, and integrin family genes (ITGA1, ITGAV, ITGA11, ITGB5) and ADAMTS2 were identified as key hub genes. Conclusions This study provides a transcriptome-wide landscape of m6A methylation during endothelial differentiation of BM-MSCs and identifies key regulatory pathways and hub genes potentially involved in this process. These findings suggest that m6A-mediated epitranscriptomic regulation plays an important role in MSC endothelial differentiation and angiogenesis.

Background: A prior retrospective single-center study involving patients with chronic limb-threatening ischemia (CLTI) demonstrated that sciatic nerve atrophy (SNA) is associated with impaired wound healing (IWH) and reduced amputation-free survival (AFS). We conducted a prospective single-center pilot study to validate the prognostic implications of SNA in predicting wound healing and AFS.Methods: Patients diagnosed with CLTI and associated tissue loss were recruited for participation in this prospective, noninterventional study. The cross-sectional area (CSA) of the sciatic nerve at the mid-to-lower femoral quarter was quantified utilizing computed tomography imaging. SNA was identified based on the predefined CSA threshold. Patient outcomes were evaluated through outpatient clinic visits and telephone follow-ups. Outcomes assessed included wound healing rate, adverse wound outcomes (AWO), and AFS.Results: In the cohort of 52 limbs with CLTI from 52 patients, 19 individuals were categorized into the SNA group. The 6-month wound healing rate was significantly lower in the SNA group (15.8%) compared to the normal group (87.9%) (p < 0.001). The sensitivity and specificity of SNA for predicting AWO at 6 months were 80.0% and 90.6%, respectively. Patients in the SNA group had significantly lower AFS at 1 year (68.4% vs 93.9%, p = 0.011). Multivariable analysis further established that SNA was an independent prognostic factor for both AWO (hazard ratio [HR]: 0.113; 95% CI: 0.034-0.381; p < 0.001) and AFS (HR: 6.135; 95% CI: 1.236-30.303; p = 0.026) following endovascular therapy (EVT).Conclusions: SNA was identified as a predictor for AWO and AFS in patients with CLTI after EVT. Future research should involve rigorous basic and large-scale clinical studies to elucidate the association between SNA and prognosis in patients with peripheral artery disease (PAD)/CLTI and explore the underlying pathophysiological mechanisms.

ABSTRACT This study investigated the current readiness for hospital discharge (RHD) among patients with lower extremity peripheral arterial disease (PAD) following endovascular revascularization within an enhanced recovery after surgery (ERAS) model and analyzed its associated factors. This cross‐sectional study was conducted at a large tertiary hospital in China. A total of 200 lower extremity PAD patients was conducted between December 2024 and August 2025. Data were collected using a general information questionnaire, the RHD Scale, and the Quality of Discharge Teaching Scale. The total score for RHD was 92.31 ± 16.10, and the total score for discharge teaching quality was 166.16 ± 18.72. The RHD score was positively correlated with the discharge teaching quality score (r = 0.400, p < 0.001). Marital status, education level, residence, number of comorbidities, length of stay, Fontaine's stage, and discharge teaching quality were identified as factors significantly correlated with RHD. The findings indicate that overall RHD in lower extremity PAD patients undergoing endovascular revascularization treatment is moderate, suggesting that the quality of discharge guidance requires further enhancement. Medical professionals should assess the quality of discharge teaching and RHD levels in order to take targeted intervention measures. Establishing a transitional care team and implementing long‐term care management is crucial for reducing the rate of unplanned readmission.

Stenting for renal artery occlusion (RAO) remains a subject of considerable debate. We aim to observe whether stenting can improve the clinical outcomes of patients with RAO. Patients with atherosclerotic unilateral RAO and at least 12 months of follow-up were included (n = 42) and were divided into the stenting group (n = 30) and the failed-stenting group (n = 12) based on their surgical outcomes. Blood pressure, serum creatinine, and clinical end point (major adverse cardiovascular or renal events) were recorded. At the last follow-up, there was no significant difference in BP and medication usage between the two groups of patients. Compared with failed revascularization, successful stenting was associated with reduced risk for renal function deterioration (p = 0.035) and clinical end point (p = 0.009). Kaplan-Meier (K-M) analysis showed a benefit of stenting on event-free survival (log-rank p = 0.029) and dialysis-free survival (log-rank p = 0.049). In conclusion, stenting plus medical therapy is effective in slowing the deterioration of renal function and preventing clinical events in patients with atherosclerotic unilateral RAO.

To investigate magnetic resonance imaging (MRI)-based radiomics for predicting renal function response for patients treated for atherosclerotic renal artery stenosis (ARAS) by endoluminal means. A cohort of 146 ARAS patients who underwent stenting was analyzed, with retrospective training and prospective validation groups delineated based on the treatment timing. Patients were categorized into benefit and no-benefit groups based on postoperative renal function during follow-up. Optimal radiomics labels were selected from regions of interest (ROIs) including the stenotic side and both kidneys. The nomogram combined optimal radiomics signatures with independent clinical factors using multivariable logistic regression. Shapley Additive exPlanations (SHAP), decision curve analysis (DCA), the net reclassification index (NRI), and the total integrated discrimination index (IDI) were conducted to determine the clinical usefulness of the nomogram. Split renal function of the stenotic side and diabetes emerged as independent clinical predictors. A nomogram, incorporating these clinical factors and radiomics features from the stenotic side and both kidneys, achieved area under the curve (AUCs) of 0.927 (0.861–0.979) and 0.904 (0.819–0.972) in the training and test groups, respectively, for predicting benefits. The clinical-radiomics model significantly improved diagnostic performance (p = 0.001 and p = 0.011 for the training and test groups, respectively). DCA, NRI, and IDI analyses suggested the nomogram's superiority. SHAP analysis highlighted the radiomics feature from stenotic side kidney as the most critical predictive feature. Both MRI radiomics and clinical factors may be valuable in pre-treatment counseling of ARAS patients who may benefit from endovascular treatment.

Background:There is a growing concern regarding the risk of cerebral hyperperfusion syndrome (CHS) associated with simultaneous bilateral carotid artery stenting (SBCAS). This retrospective, single-center, observational cohort study aimed to compare early cerebral hemodynamic changes between patients treated with SBCAS and those treated with unilateral carotid artery stenting (UCAS) through the use of transcranial color-coded Doppler (TCCD). Methods:Data from 25 patients who underwent SBCAS and 165 patients who underwent UCAS between June 2013 and June 2023 were analyzed. TCCD monitoring was conducted for all patients prior to and 1 hour following the carotid artery stenting (CAS) procedure. A propensity score matching (PSM) method was employed to match patients from the SBCAS and UCAS groups in a 1:2 ratio. Key parameters compared between groups included middle cerebral artery peak systolic velocity (MCA-PSV), pulsatility index, blood pressure, and complications. Results:A statistically significant increase in ipsilateral MCA-PSV was detected in both the SBCAS group (35% increase; from 78±25 to 105±22 cm/s; P<0.001) and the UCAS group (27% increase; from 79±23 to 100±28 cm/s; P<0.001). Notably, the increase in ipsilateral MCA-PSV in the SBCAS group was substantially greater than that in the UCAS group (35% vs. 27%; P=0.043). Three and four cases of cerebral hyperperfusion (CHP) were identified in the SBCAS group and the UCAS group, respectively. Only one case of CHS was recorded in the UCAS group. A total of 22 patients in the PSM SBCAS group and 34 patients in the PSM UCAS group were analyzed. The increase in ipsilateral MCA-PSV in the PSM SBCAS group was significant, higher than that in the PSM UCAS group (48% vs. 31%; P=0.031). However, no significant differences in the incidence of CHP were found between the two groups. Conclusions:The increase in ipsilateral MCA-PSV was significantly greater in the SBCAS group than in the UCAS group. The risk of CHP and CHS was not higher in the SBCAS group as compared to the UCAS group. The use of TCCD post-CAS may be beneficial in monitoring and potentially preventing CHS, particularly in patients undergoing SBCAS, and is therefore recommended.

Bilateral renal artery stenosis is a major cause of secondary hypertension, yet the benefits of percutaneous transluminal renal angioplasty and stenting in patients without Pickering syndrome remain uncertain. This retrospective study evaluated its effects on blood pressure control, medication burden, and renal function stability in 69 patients treated between 2010 and 2021. Patients with heart failure or pulmonary edema were excluded. Over a mean follow-up of 67.25 months, systolic and diastolic blood pressure significantly decreased, from 152.97 ± 16.97 to 135.48 ± 15.09 mmHg (p < 0.01) and from 84.33 ± 10.69 to 77.83 ± 11.94 mmHg (p < 0.01), respectively. The number of antihypertensive medications was also reduced, from 2.41 ± 1.28 to 1.68 ± 0.93 (p < 0.01). Renal function remained stable overall, with no significant change in serum creatinine (p = 0.094). However, patients with preoperative proteinuria exhibited greater deterioration in renal function during follow-up (p = 0.039), suggesting it may predict post-procedural outcomes. These findings indicate that percutaneous transluminal renal angioplasty and stenting provide sustained benefits in blood pressure control and medication reduction for bilateral renal artery stenosis patients without Pickering syndrome, though those with proteinuria may be at higher risk of renal function decline. Further studies are needed to refine treatment strategies based on individual risk factors.

OBJECTIVE:To explore the potential of Intravoxel Incoherent Motion Diffusion (IVIM) and Arterial Spin Labeling (ASL) in predicting the short-term effectiveness of post-revascularization for severe atherosclerotic renal artery stenosis. MATERIAL AND METHODS:A retrospective analysis of 88 cases from October 2018 to February 2023 was conducted. Patients were divided into Responder and Non-Responder groups based on renal function outcomes at their last follow-up. Clinical data were compared between the groups, and preoperative functional MRI images were analyzed. ROIs were outlined for the affected and both kidneys. Measurements included ASL-derived renal blood flow (RBF), IVIM's pseudo-diffusion coefficient (D*), perfusion fraction (f), true diffusion coefficient (D), and the conventional apparent diffusion coefficient (ADC).Multivariate logistic regression identified independent clinical predictors of benefit, and a clinical prediction model was developed. Model performance was assessed using Receiver Operating Characteristic (ROC) curves and Decision Curve Analysis(DCA) curves. RESULTS:In the training cohort of 54 non-responders and 34 responders, no quantitative parameters of bilateral kidneys showed statistical significance in predicting Responders (all p > 0.05). Pre-treatment eGFR, presence of diabetes, and the D value of the affected kidney were identified as independent factors for predicting short-term treatment effectiveness. The combined clinical-functional imaging model yielded a higher AUC at 0.796 (95 % CI: 0.690-0.897). Decision curve analysis further confirmed the better net benefit of combined model. CONCLUSION:Beyond clinical characteristics, functional MRI had the potential to predict response of stenting for severe atherosclerotic renal artery stenosis.

PURPOSE:To evaluate the feasibility and clinical utility of non-contrast magnetic resonance angiography (NC-MRA) using a modified balanced steady-state free precession (b-SSFP) technique combined with arterial spin labeling (ASL) for post-embolotherapy follow-up of renal artery aneurysms (RAAs), with digital subtraction angiography (DSA) as the reference standard. METHOD:A total of 57 patients with RAAs underwent embolotherapy between June 2013 and July 2024. Among them, 15 RAAs from 14 patients underwent post-embolization surveillance with the NC-MRA and DSA. NC-MRA was performed at 12 months after coil embolization, followed by DSA. On NC-MRA images, complete occlusion is indicated by the absence of high signal within the aneurysm, whereas on DSA images, complete occlusion is defined as the absence of contrast enhancement within the aneurysm. We compare the NC-MRA and DSA results for each aneurysm during follow-up. RESULTS:Of the 15 aneurysms, 12 achieved complete occlusion and 3 exhibited incomplete occlusion. There was no aneurysmal growth, and no adverse events such as rupture or renal infarction occurred. We acquired 15 groups of follow-up MRA and DSA images, and the results were in perfect concordance. CONCLUSION:The NC-MRA using the modified b-SSFP combined with ASL shows good agreement with DSA in assessing recanalization of RAAs after embolotherapy and may serve as a reliable, non-invasive follow-up modality.

Background:Drug-delivering devices have shown efficacy in clinical trials and are widely used for femoropopliteal artery disease. However, the optimal strategy for complex lesions, such as TransAtlantic Inter-Society Consensus (TASC) C and D lesions, remains debated in real-world practice. This propensity score-matched study aimed to compare the mid-term outcomes between a double-drug strategy [drug-coated balloon (DCB) combined with systemic drug-eluting stents (DES)] and a DCB bailout strategy (DCB with bailout bare-metal stents) in patients with TASC C and D femoropopliteal lesions. Methods:This retrospective single-center study included TASC C and D femoropopliteal patients treated with DCB from October 2016 to July 2024. Propensity score matching (PSM) was performed in a 1:3 ratio, with one patient in the double-drug strategy group for every three in the DCB bailout group. The primary endpoint was 24-month primary patency. Secondary endpoints included freedom from clinically-driven target lesion revascularization (CD-TLR), mortality, complications, symptom improvement, and risk factors for restenosis. Results:After PSM, 32 pairs of patients were analyzed. Baseline characteristics were well-balanced [standardized mean difference (SMD) <0.2 for all covariates]. Primary patency rates at 24 months were comparable (double-drug vs. DCB bailout: 64.5% vs. 76.4%, P=0.76). Freedom from CD-TLR showed no significant difference at 24 months (double-drug vs. DCB bailout: 95.8% vs. 79.1%, P=0.20). The double drug group demonstrated superior Rutherford category improvement (P=0.042). Mortality and complication rates were similar between groups. Dyslipidemia was identified as an independent predictor of loss of primary patency [hazard ratio (HR) =3.03, P=0.024]. Conclusions:The double-drug strategy and DCB bailout strategy yielded comparable 24-month patency and freedom from target lesion revascularization (TLR) in TASC C and D lesions.

Background: Atherosclerotic renal artery stenosis (ARAS) is a condition where the renal arteries become narrowed due to atherosclerosis, leading to reduced blood flow to the kidneys and various renal complications. The effectiveness of interventional treatments, such as renal artery angioplasty and stenting, remains debated, making patient selection for these procedures challenging. Summary: This review focuses on the diagnosis and management of ARAS, with a particular emphasis on the potential role of functional MRI in evaluating renal function and mechanisms. By summarizing current diagnostic approaches and outcomes of interventional treatments, the review highlights the importance of informed clinical decision-making in ARAS management. Functional MRI emerges as a promising non-invasive tool to assess renal function, aiding in patient stratification and treatment planning.Key Messages:The efficacy of interventional treatments for ARAS requires further investigation and careful patient selection. Functional MRI holds promise as a non-invasive means to assess renal function and mechanisms, potentially guiding more effective clinical decisions in ARAS management. Advancing research in diagnostic methods, particularly functional MRI, can enhance our understanding and improve the treatment outcomes for ARAS patients.

Background:Spontaneous renal artery dissection (SRAD) is a rare cause of renal failure and renovascular hypertension, with the diagnosis often being delayed and treatment varying across different centers. The objective of this retrospective cohort study was to scrutinize the characteristics, treatment modalities, and outcomes of patients with SRAD at our center over the past ten years. Furthermore, the study sought to identify the most suitable treatment options for different categories of patients with SRAD. Methods:Data from 21 consecutive patients who presented with symptoms of SRAD from December 2013 to December 2023 were collected. Lesion characteristics, treatment options, blood pressure (BP) control, serum creatinine and estimated glomerular filtration rate (eGFR) were analyzed. A paired t-test was used for comparisons of BP, serum creatinine, and eGFR. An independent samples t-test was used to analyze baseline BP and BP change in different treatment groups. Results:The mean age, weight, and height of patients with SRAD was 49.2±13.0 (range, 18-69) years, 69.0±9.7 (range, 50-80) kg, and 1.7±0.1 (range 1.6-1.8) m, respectively. New-onset hypertension was found in 8 (38.1%) patients. Renal artery dissecting aneurysm and renal artery stenosis were found in 1 (4.8%) and 4 (19.0%) patients, respectively. Supportive medical treatment alone, endovascular intervention, and nephrectomy were required in 15, 4 and 2 cases, respectively. Stable renal function and satisfactory hypertension control were obtained in all treatment groups, with a median follow-up of 18.1 (range, 12-32) months. Conclusions:Medical management is a reasonable choice in most patients with SRAD. Interventional management is an efficacious strategy for the management of renovascular hypertension and the preservation of renal function.

PurposeTo assess the feasibility and efficacy of percutaneous transluminal renal angioplasty (PTRA) for pediatric renovascular hypertension (RVH) secondary to total renal artery occlusion (RAO).MethodsFrom 2011 to 2021, 13 pediatric patients with RVH confirmed with 14 occluded renal artery lesions were reviewed. The mean age was11.2 years (range 4 to 16). Nine lesions involved main artery occlusion, while five lesions featured branch occlusion. Blood Pressure Ratio (BPR) was defined as the ratio of the actual BP value to the 95th percentile value adjusted for age, gender, and height.ResultsPTRA was performed on nine patients (9/13, 69%). Technical success was achieved in five patients (5/9, 56%), with stent placement in two children (2/9, 22%). During the 12-month follow-up, restenosis was identified in two stent-receiving patients at the 12-month follow-up visit (2/9, 22%). Mean systolic BPR decreased from 1.20 ± 0.07 to 0.96 ± 0.06 (p = 0.003), mean diastolic BPR decreased from 1.19 ± 0.07 to 0.95±0.08 (p = 0.005) and the number of required medications decreased from 3.8 ± 0.8 to 2.4 ± 0.9 (p = 0.052) following PTRA. Subsequent to PTRA, the mean GFR of the occluded kidney improved from 19.5 ± 12.3 mL/ min to 36.3 ± 10.8 mL/ min (p = 0.007) and the mean longitudinal dimension of the affected kidneys significantly increased from 8.2 ± 1.5 cm to 9.2 ± 1.7 cm (p = 0.006).ConclusionsEndovascular treatment is feasible for pediatric RAO, results in acceptable BP control and preserves renal function.

Background Thromboangiitis obliterans (TAO) is a vascular condition characterized by poor prognosis and an unclear etiology. This study employs Mendelian randomization (MR) to investigate the causal impact of circulating inflammatory proteins on TAO. Methods In this MR analysis, summary statistics from a genome-wide association study meta-analysis of 91 inflammation-related proteins were integrated with independently sourced TAO data from the FinnGen consortium's R10 release. Methods such as inverse variance weighting, MR–Egger regression, weighted median approaches, MR-PRESSO, and multivariable MR (MVMR) analysis were utilized. Results The analysis indicated an association between higher levels of C–C motif chemokine 4 and a reduced risk of TAO, with an odds ratio (OR) of 0.44 (95% confidence interval [CI]: 0.29–0.67; p = 1.4 × 10−4; adjusted p = 0.013). Similarly, glial cell line-derived neurotrophic factor exhibited a suggestively protective effect against TAO (OR: 0.43, 95% CI: 0.22–0.81; p = 0.010; adjusted p = 0.218). Conversely, higher levels of C–C motif chemokine 23 were suggestively linked to an increased risk of TAO (OR: 1.88, 95% CI: 1.21–2.93; p = 0.005; adjusted p = 0.218). The sensitivity analysis and MVMR revealed no evidence of heterogeneity or pleiotropy. Conclusion This study identifies C–C motif chemokine 4 and glial cell line-derived neurotrophic factor as potential protective biomarkers for TAO, whereas C–C motif chemokine 23 emerges as a suggestive risk marker. These findings elucidate potential causal relationships and highlight the significance of these proteins in the pathogenesis and prospective therapeutic strategies for TAO.

Portal vein thrombosis (PVT) is commonly encountered in patients with cirrhosis, challenging our understanding of its development, particularly the ambiguous contribution of inflammation. This study utilized Mendelian randomization (MR) to explore the causal impact of circulating inflammatory markers on PVT.Employing a two-sample MR framework, we merged genome-wide association study (GWAS) meta-analysis findings of 91 inflammation-associated proteins with independent PVT data from the FinnGen consortium's R10 release. A replication analysis was performed using a distinct GWAS dataset from the UK Biobank. Inverse variance weighting, MR-Egger regression, weighted median estimator, and Mendelian Randomization Pleiotropy RESidual Sum and Outlier were used for analysis, supplemented by multivariable MR (MVMR) to adjust for cirrhosis effects.Findings indicate a significant inverse association between the genetically inferred concentration of eukaryotic translation initiation factor 4E-binding protein 1 (4E-BP1) and PVT risk, evidenced by an odds ratio (OR) of 0.37 (95% confidence interval [CI]: 0.21-0.67; p = 9.2 × 10-4; adjusted for multiple testing p = 0.084). This association was corroborated in the replication phase (OR = 0.39, 95% CI: 0.17-0.93; p = 0.03) and through MVMR analysis (OR = 0.34, 95% CI: 0.15-0.79; p = 0.012). Sensitivity analyses disclosed no evidence of heterogeneity or pleiotropy.Our investigation emphasizes the 4E-BP1 as a protective factor against PVT, underscoring its potential relevance in understanding PVT pathogenesis and its implications for diagnosis and therapy.

Background: The Global Limb Anatomic Staging System (GLASS) was proposed to assess the procedural complexity and technical failure rate and stratify the anatomic pattern of chronic limb-threatening ischemia (CLTI). However, more evidence is needed to validate the GLASS in staging outcomes after endovascular therapy in patients with CLTI treated with drug-coated balloons (DCBs). This study aims to evaluate the role of the GLASS in predicting outcomes of CLTI patients treated with DCBs. Methods: This multicenter, retrospective cohort study enrolled patients with CLTI treated with DCBs from July 2016 to June 2019. GLASS stages were assigned for every limb. The limb-based patency (LBP) rate, clinically driven target lesion revascularization (CD-TLR) rate, clinical improvement, and safety endpoints were analyzed and compared across the GLASS stages over 12 months of follow-up. Risk factors for the loss of LBP were identified using Cox regression analysis. Results: A total of 90 limbs were enrolled, with 55 (61.1%) having isolated femoropopliteal lesions and 35 (38.9%) having femoropopliteal and infrapopliteal lesions. Of the limbs, 17 (18.9%), 12 (13.3%), and 61 (67.8%) were assigned to GLASS stages I, II, and III, respectively. The Kaplan-Meier estimate of the 12-month LBP was 65.4%, and no difference was found among the different stages (stage I 81.1%; stage II 85.2%; stage III 54.4%; P=0.080). The LBP was lower in stage III than in stages I and II combined (stage I and II 83.5%; stage III 54.4%; P=0.027). Similar results were found for the freedom from CD-TLR rates among the different stages. The ankle-brachial index values improved from 0.42±0.29 to 0.78±0.35 at follow-up (P<0.001). The rates of mortality, any amputation, and major amputation were similar among the groups. GLASS stage III and coronary heart disease were identified as independent risk factors for the loss of LBP at 12 months. Conclusions: The 1-year LBP and freedom from CD-TLR rates were lower in GLASS stage III than in stages I and II. The GLASS classification could predict the outcomes of CLTI patients with femoropopliteal lesions treated with DCB.

Background:Renovascular disease underlies 5-10% of all childhood hypertension. We evaluated the long-term outcomes of percutaneous transluminal renal angioplasty (PTRA) for pediatric renovascular hypertension (RVH).Methods:Data from 37 children with RVH who underwent PTRA of 45 lesions at our center from January 2010 to January 2022 were retrospectively evaluated. Postoperative blood pressure (BP), glomerular filtration rate (GFR), affected kidney size, restenosis, and complications were analyzed.Results:Mean age, weight, and height of patients at first PTRA was 11.51±4.57 (range, 3-17) years, 45.37±22.29 (range, 13.40-106.00) kg, and 1.46±0.26 (range, 0.92-1.85) m, respectively. Technical success was achieved in 33 of 37 (89.2%) patients and 40 of 45 (88.9%) lesions, without surgery-related complications. At a median of 7.5 (range, 3-14) months, restenosis occurred in 6 (16.7%) patients and 7 (16.3%) lesions (all ostial and 6 with a length >15 mm), yielding a clinical beneficial rate from first PTRA of 83.3%. At 18- and 20-month follow-up the mean kidney length (29 kidneys) increased from 8.89±1.55 to 9.79±1.51 cm (P<0.001) and mean GFR (34 kidneys) from 32.28±19.22 to 41.24±13.24 mL/min (P<0.001).Conclusions:In this retrospective analysis, PTRA for the treatment of pediatric RVH can achieve satisfactory results. Angioplasty was associated with improved BP control and long-term preservation of renal function, as reflected by an increase in affected kidney size and a higher GFR.