title: Renal denervation for resistant hypertension using an irrigated radiofrequency balloon: 12-month results from the Renal Hypertension Ablation System (RHAS) trial.
abstract: OBJECTIVE
  Renal denervation using the point-by-point application of radiofrequency energy delivered by the first-generation Symplicity system is effective in lowering office blood pressure but may be time-consuming. The OneShot Renal Denervation System with a balloon-mounted spiral electrode potentially shortens and simplifies the procedure. This study is a hypothesis-generating first-in-human study to assess feasibility, and to provide preliminary efficacy and safety data.
  
  
  RESULTS
  Eligible patients had a baseline office systolic blood pressure ≥160 mmHg (or ≥150 mmHg for diabetics) and were on two or more antihypertensive medications. Nine patients were enrolled. The primary endpoint, the insertion of the OneShot balloon into each renal artery and the delivery of radiofrequency energy, was achieved in 8/9 (89%) of patients. The one failure (the first patient) was due to generator high-impedance safety shut-off threshold set too low for humans. Adverse events were minor. No patient developed renal artery stenosis. Baseline BP was 185.67 ± 18.7 mmHg and the reductions at 1, 3, 6 and 12 months were 30.1 ± 13.6 (p=0.0004), 34.2 ± 20.2 (p=0.002), 33.6 ± 32.2 (p=0.021) and 30.6 ± 22.0 (p=0.019).
  
  
  CONCLUSIONS
  The OneShot renal denervation system successfully delivered radiofrequency energy to the renal arteries in a short and straightforward procedure. Australian New Zealand Clinical Trials Registry - URL: anzctr.org.au. Trial identification: ACTRN12611000987965.
authors.affiliation: Mercy Angiography, Newmarket, Auckland, New Zealand. johno@mercyangiography.co.nz
authors.forename: John A
authors.initials: JA
authors.lastname: Ormiston
authors.forename: Timothy
authors.initials: T
authors.lastname: Watson
authors.forename: Niels
authors.initials: N
authors.lastname: van Pelt
authors.forename: Ralph
authors.initials: R
authors.lastname: Stewart
authors.forename: James T
authors.initials: JT
authors.lastname: Stewart
authors.forename: Jonathon M
authors.initials: JM
authors.lastname: White
authors.forename: Robert N
authors.initials: RN
authors.lastname: Doughty
authors.forename: Fiona
authors.initials: F
authors.lastname: Stewart
authors.forename: Rhona
authors.initials: R
authors.lastname: Macdonald
authors.forename: Mark W I
authors.initials: MW
authors.lastname: Webster
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D017763:Autonomic Denervation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D001794:Blood Pressure / Q000187:drug effects; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation*; D004351:Drug Resistance; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D007668:Kidney / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D011446:Prospective Studies; D007507:Therapeutic Irrigation / Q000295:instrumentation; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents