Management of the renovascular disease in children with Takayasu arteritis

Takaysu arteritis (TA), together with fibromuscular dysplasia, is the most common cause for renovascular hypertension. The diagnosis of vasculitis is important to make as these children benefit from immunosuppressive treatment. In many cases, however, it is more difficult than commonly realised to differentiate between these two diagnoses. Imaging which allows the inflamed arterial wall to be outlined, such as magnetic resonance or positron emission tomography scans, can be very helpful in this context. Revascularisation, either with angioplasty or surgery, seems to be effective and safe, also in children with TA. Patients with inactive disease have a more successful outcome and experience fewer complications from the intervention than those with active on-going inflammation.