Endovascular radiofrequency renal denervation in treating refractory arterial hypertension: a preliminary experience.
OBJECTIVE
This study was done to investigate the efficacy and safety of percutaneous renal denervation with the Symplicity catheter for reducing blood pressure in patients with essential hypertension resistant to medical therapy (systolic blood pressure >160 mmHg despite the use of three or more antihypertensive drugs, including a diuretic).


METHODS
In September 2010, five patients affected by essential hypertension resistant to medical therapy were treated. All patients were studied by computed tomography angiography (CTA) of the renal arteries before the procedure and underwent follow-up at 30 and 60 days with colour Doppler ultrasound (CDUS) with evaluation of resistive index, glomerular filtration rate (GFR), 24-h blood pressure and serum catecholamine concentration. Student's t test was used to assess the effectiveness of the procedure in lowering blood pressure.


RESULTS
In treated patients, mean blood pressure at baseline was 171/100 mmHg [standard deviation (SD) ± 8/10]; mean GFR was 91.6 ml/min/1.73 m(2) (SD ± 15). Blood pressure after the procedure was reduced by -18/-5 and -13/-10 mmHg at 30 and 60 days, respectively, with a mean medication reduction of 3.6. No complications occurred during the intra- or periprocedural period or during short-term follow-up.


CONCLUSIONS
The Symplicity system proved to be efficacious and without serious adverse events in reducing blood pressure and antihypertensive medication use in patients affected by essential hypertension resistant to medical therapy. Although encouraging, our data are preliminary and need to be validated by larger prospective randomised studies.
Dipartimento di Diagnostica per Immagini, Imaging Molecolare, Radiologia Interventistica e Radioterapia, Fondazione Policlinico Universitario Tor Vergata, Viale Oxford 81, 00133, Roma, Italy.
G
G
Simonetti
A
A
Spinelli
R
R
Gandini
V
V
Da Ros
E
E
Gaspari
I
I
Coco
M
M
De Francesco
D
D
Santucci
N
N
Di Daniele
R
R
Lauro
D001794:Blood Pressure; D017115:Catheter Ablation / Q000379:methods*; D003714:Denervation / Q000379:methods*; D004351:Drug Resistance; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000601:surgery*; D007668:Kidney / Q000294:innervation*