title: Denervation (ablation) of nerve terminalis in renal arteries: early results of interventional treatment of arterial hypertension in Poland.
abstract: BACKGROUND
  Arterial hypertension is one of the main causes of cardiovascular disease morbidity and overall mortality.
  
  
  OBJECTIVE
  To report the single centre experiences with changes in arterial blood pressure (BP) in patients after intra-arterial application of radiofrequency (RF) energy to cause renal sympathetic efferent and somatic afferent nerve and report vascular and kidney safety in a six month follow up.
  
  
  METHODS
  Twenty-eight patients, with hypertension despite medical therapy (median age 52.02 years, range 42-72 years) consented to therapeutic renal nerve ablation. SIMPLICITY RF catheters and generator provided by Ardian (currently Medtronic Inc., USA) were used to perform renal artery angiography and ablation.
  
  
  RESULTS
  The mean BP at baseline, and after one month, three months and six months were measured [mm Hg]: systolic 176.6; 162.3 (p = 0.004); 150.6 (p < 0.001); 147.2 (p < 0.001); diastolic 100.2; 90.3 (p < 0.001); 91.79 (p = 0.03); 88.5 (p < 0.001); pulse pressure 76.57; 75.18 (p = NS); 65.80 (p < 0.001); 62.15 (p < 0.001). Neither procedure-related nor therapy-related complications were reported in the six month follow up.
  
  
  CONCLUSIONS
  In our cohort of patients, intra-arterial renal nerve denervation was not associated with either vascular or renal complications out to six months. Nerve ablation of renal arteries led to significant reduction of mean values of arterial systolic, diastolic BP and significant reduction of pulse pressure. The Polish experience is not significantly different compared to that reported in the Symplicity I and Symplicity II international cohorts. The long term durability of this therapy and its application to earlier stages of hypertension or other disease states will require further investigation.
authors.affiliation: Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, John Paul II Hospital, Krakow, Poland. cool_chris@interia.pl
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Bartuś
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sadowski
authors.forename: Bogusław
authors.initials: B
authors.lastname: Kapelak
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zajdel
authors.forename: Jacek
authors.initials: J
authors.lastname: Godlewski
authors.forename: Stanisław
authors.initials: S
authors.lastname: Bartuś
authors.forename: Maciej
authors.initials: M
authors.lastname: Bochenek
authors.forename: Magdalena
authors.initials: M
authors.lastname: Bartuś
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Żmudka
authors.forename: Paul A
authors.initials: PA
authors.lastname: Sobotka
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000294:innervation*; D013562:Sympathectomy / Q000379:methods; D016896:Treatment Outcome