Catheter-based renal denervation for treatment of resistant hypertension.
BACKGROUND
Activation of renal sympathetic nerves is associated with the development of hypertension. Catheter-based renal sympathetic denervation with radiofrequency energy ablation is a new promising treatment option for resistant hypertension. We here report the first Danish experiences and results with this technique.


METHODS
Nine patients with resistant hypertension and a day-time 24-hour ambulatory blood pressure (BP) of 152/89 mmHg ± 10/10 (standard deviation) mmHg despite treatment with 5.4 ± 1.4 anti-hypertensive drugs underwent catheter-based renal sympathetic denervation with the Symplicity catheter.


RESULTS
No periprocedural complications or adverse events during follow-up were observed. Seven patients received complete ablation and two patients only partial ablation. Five patients responded to the treatment with a reduction in day-time 24-hour ambulatory BP from 158/94 ± 13/9 mmHg to 139/82 ± 10/8 mmHg (p < 0.05) at the one month follow-up and a reduction in the number of anti-hypertensive drugs from 5.4 ± 1.6 to 3.4 ± 0.9 (p < 0.05). BP in the remaining four patients was not significantly changed and antihypertensive therapy was not changed.


CONCLUSIONS
Catheter-based renal sympathetic denervation is a feasible and in several cases also effective treatment option for patients with resistant hypertension. Adequately designed controlled trials are needed to assess the long-term safety and the full potential of this treatment.
Hjertemedicinsk Afdeling, Aarhus Universitetshospital, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark. henrikvase@dadlnet.dk
Henrik
H
Vase
Ole Norling
ON
Mathiassen
Anne
A
Kaltoft
Erling Bjerregaard
EB
Pedersen
Kent Lodberg
KL
Christensen
Niels Henrik
NH
Buus
Ole
O
Lederballe
Jens Flensted
JF
Lassen
Hans Erik
HE
Bøtker
Leif
L
Thuesen
D000368:Aged; D000792:Angiography; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D017115:Catheter Ablation; D004351:Drug Resistance; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000294:innervation / Q000601:surgery*; D013562:Sympathectomy / Q000379:methods*
D000959:Antihypertensive Agents