scholarly journals Relevance of Targeting the Distal Renal Artery and Branches with Radiofrequency Renal Denervation Approaches—A Secondary Analysis from a Hypertensive CKD Patient Cohort

2019 ◽  
Vol 8 (5) ◽  
pp. 581 ◽  
Author(s):  
KIUCHI ◽  
SCHLAICH ◽  
CHEN ◽  
VILLACORTA ◽  
HO ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Renal Denervation ◽  
Secondary Analysis ◽  
Distal Segment ◽  
Renal Arteries ◽  
Lowering Effect ◽  
Post Hoc

We searched for an association between changes in blood pressure (BP) at 12 and 24 months after renal denervation (RDN) and the different patterns of ablation spots placement along the renal artery vasculature. We performed a post-hoc analysis of a 24‐month follow‐up evaluation of 30 patients who underwent RDN between 2011 and 2012 using our previous database. Patients who had (i) resistant hypertension, as meticulously described previously, and (ii) Chronic kidney disease (CKD) stages 2, 3 and 4. Correlations were assessed using the Pearson or Spearman correlation tests as appropriate. The mean change in systolic ambulatory BP monitoring (ABPM) compared to baseline was –19.4 ± 12.7 mmHg at the 12th (p < 0.0001) and –21.3 ± 14.1 mmHg at the 24th month (p < 0.0001). There was no correlation between the ABPM Systolic Blood Pressure (SBP)-lowering effect and the total number of ablated spots in renal arteries (17.7 ± 6.0) either at 12 (r = –0.3, p = 0.1542) or at 24 months (r = –0.2, p = 0.4009). However, correlations between systolic BP-lowering effect and the number of ablation spots performed in the distal segment and branches were significant at the 12 (r = –0.7, p < 0.0001) and 24 months (r = –0.8, p < 0.0001) follow-up. Our findings indicate a substantial correlation between the numbers of ablated sites in the distal segment and branches of renal arteries and the systolic BP-lowering effect in the long-term.

scholarly journals Unilateral renal sympathetic denervation may reduce blood pressure in patients with refractory hypertension

2015 ◽  
Vol 9 (4) ◽  
pp. 362
Author(s):  
Aurelio Negro ◽  
Rosaria Santi ◽  
Antonio Manari ◽  
Franco Perazzoli
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Renal Denervation ◽  
Antihypertensive Drugs ◽  
Renal Sympathetic Denervation ◽  
Caucasian Woman ◽  
Left Renal Artery ◽  
Refractory Hypertension ◽  
The Mean

A 52-year-old Caucasian woman with essential resistant and refractory hypertension despite optimal medical therapy, including 6 different antihypertensive drugs was referred for the catheter-based renal denervation. Due to unfavourable anatomy because of non-critical fibromuscular dysplasia on the right renal artery, renal denervation of only the left renal artery was performed. Before and after the renal denervation, the patient’s blood pressure was monitored by <em>office</em> measurements and ambulatory blood pressure measurements (ABPM). Before the procedure, the mean <em>office</em> blood pressure was 157/98 mmHg; at ABPM, the mean blood pressure values were 145/94 mmHg. At 6 months of follow-up, the mean <em>office</em> blood pressure was 134/90 mmHg and 121/76 mmHg at ABPM. In latest 12 months of follow-up, <em>office</em> and ABPM blood pressure were 125/80 and 127/80 mmHg respectively. This unique case suggests that unilateral renal denervation may be effective in lowering blood pressure in patients with refractory hypertension and unfavorable renal arteries anatomy.

scholarly journals Long-term benefit of renal denervation on blood pressure control in a patient with hemorrhagic stroke

2019 ◽  
Vol 7 ◽  
pp. 2050313X1987097
Author(s):  
Francesco Versaci ◽  
Giuseppe Andò ◽  
Marcello Chiocchi ◽  
Francesco Romeo
Keyword(s):  
Blood Pressure ◽  
Renal Denervation ◽  
Hemorrhagic Stroke ◽  
Blood Pressure Reduction ◽  
Pressure Control ◽  
Refractory Hypertension ◽  
Sustained Efficacy ◽  
Term Benefit

A 49-year-old man with malignant hypertension had been admitted with hemorrhagic stroke. Refractory hypertension had been observed during hospitalization and the decision had been made to perform renal denervation. A significant blood pressure reduction was obtained immediately after renal denervation and persists at 2-year follow-up. This case demonstrates the long-term sustained efficacy of renal denervation performed in the acute phase of hemorrhagic stroke. In addition, it supports the notion that renal denervation–induced normalization of blood pressure may contribute to better outcomes in a challenging setting such as intracranial bleeding.

scholarly journals Renal Artery Stenting Associated With Improvement in Renal Function and Blood Pressure Control in Long-Term Follow-Up

2016 ◽  
Vol 41 (3) ◽  
pp. 278-287 ◽  
Author(s):  
Krzysztof Milewski ◽  
Wojciech Fil ◽  
Piotr Buszman ◽  
Małgorzata Janik ◽  
Wojciech Wanha ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Renal Artery ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Renal Artery Stenting ◽  
Long Term Follow Up

scholarly journals Main Renal Artery Plus Branch Ablation in the Treatment of Resistant Hypertension with Renal Denervation

2021 ◽  
Author(s):  
Zong-Jun Liu
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Resistant Hypertension ◽  
Average Energy ◽  
Office Blood Pressure ◽  
Significant Difference ◽  
Main Renal Artery ◽  
Long Term Follow Up

Objective: To study the safety and efficacy of denervation of renal artery branches in the treatment of resistant hypertension.Methods: Sixty patients with resistant hypertension were enrolled. The patients were randomly assigned to the mainrenal artery plus branch ablation group or the main renal artery ablation group. The clinical data and operation-relatedparameters, including number of ablation points, temperature, and average energy, were recorded. Ambulatory bloodpressure were taken for all patients at the baseline and at 6 months after treatment. Office blood pressure was recordedbefore treatment and after treatment every 3 months for 2 years.Results: Sixty patients with resistant hypertension were enrolled in this study. There were 30 patients in each group.Angiography was performed after ablation. No renal artery complications, such as stenosis and dissection, occurredin the two groups. There was no significant difference in age, sex, BMI, comorbid disease, and medication betweenthe two groups (P > 0.05). The number of ablation points for the main renal artery plus branch ablation group wasgreater than that for the main renal artery ablation group. The office blood pressure and 24-hour blood pressure weresignificantly lower 6 months after treatment than before treatment in both groups (P < 0.05). Office blood pressure inthe main renal artery plus branch ablation group was lower than that in the main renal artery ablation group during the3–12-month follow-up period, with a statistical difference. However, as the follow-up time increased, the differencedisappeared.Conclusion: The results of this study show that main renal artery plus branch ablation is a safe interventional method,but there was no obvious advantage on long-term follow-up compared with only main renal artery ablation.

scholarly journals Effect of renal denervation on long-term outcomes in patients with resistant hypertension

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Bo Liang ◽  
Yi Liang ◽  
Rui Li ◽  
Ning Gu
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Renal Denervation ◽  
Pressure Control ◽  
Treatment Method ◽  
Control Effect ◽  
First Choice ◽  
Long Term Follow Up

AbstractIncreasing studies strongly prove that renal denervation, a minimally invasive surgery, is a promising new non-drug treatment method that can effectively control blood pressure in patients with resistant hypertension, but the evaluation of the long-term blood pressure control effect of renal denervation for resistant hypertension is still lacking. Here, we critically review current long-term follow-up data about the use of renal denervation for RH to comprehensively evaluate the effectiveness of renal denervation for RH, and to provide practical guidance for practitioners who are establishing a renal denervation service. Limited by the current research, many problems need to be solved before renal denervation is applied to RH. In addition, ambulatory blood pressure should be the first choice for the evaluation of blood pressure. Finally, the continuous antihypertensive effect of renal denervation in different renal denervation systems also needs to be strictly compared.

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