title: Endovascular treatment of resistant and uncontrolled hypertension: therapies on the horizon.
abstract: The treatment of resistant hypertension has undergone remarkable advancements in recent years. Endovascular radio frequency renal sympathetic denervation (RSD) has shown initial success in treating resistant hypertension by targeting the connection between the brain and renal sympathetic nerves. However, the encouraging results of first-generation RSD have been tempered by important procedural limitations and a need for long-term results of safety and efficacy. In an effort to build on early clinical success, several second-generation RSD technologies are now being developed that may improve procedural safety and efficacy. Preliminary evidence for some of the latest technologies is now available. In this review, we summarize the current evidence in support of RSD and consider unique features of several new technologies that are likely to refine the endovascular treatment of resistant hypertension.
authors.affiliation: Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Bunte
authors.forename: Eduardo
authors.initials: E
authors.lastname: Infante de Oliveira
authors.forename: Mehdi H
authors.initials: MH
authors.lastname: Shishehbor
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D017115:Catheter Ablation; D057785:Catheters; D004351:Drug Resistance; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation; D004867:Equipment Design; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D007668:Kidney / Q000294:innervation*; D013562:Sympathectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017211:Treatment Failure; D014464:Ultrasonic Therapy
chemical_list: D000959:Antihypertensive Agents