title: Eligibility for renal denervation: anatomical classification and results in essential resistant hypertension.
abstract: OBJECTIVE
  To classify the renal artery (RA) anatomy based on specific requirements for endovascular renal artery denervation (RDN) in patients with drug-resistant hypertension (RH).
  
  
  METHODS
  The RA anatomy of 122 consecutive RH patients was evaluated by computed tomography angiography and classified as two types: A (main RA ≥20 mm in length and ≥4.0 mm in diameter) or B (main RA <20 mm in length or main RA <4.0 mm in diameter). The A type included three subtypes: A1 (without accessory RAs), A2 (with accessory RAs <3.0 mm in diameter), and A3 (with accessory RAs ≥3.0 mm in diameter]. A1 and A2 types were eligible for RDN with the Simplicity Flex catheter. Type B included twi subtypes based on the main RA length and diameter. Patients were accordingly classified into three eligibility categories: complete (CE; both RAs were eligible), partial (PE; one eligible RA), and noneligibility (NE; no eligible RA).
  
  
  RESULTS
  Bilateral A1 type was the most prevalent and was observed in 48.4 % of the patients followed by the A1/A2 type (18 %). CE, PE, and NE were observed in 69.7, 22.9, and 7.4 % of patients, respectively. The prevalence of accessory RAs was 41 %.
  
  
  CONCLUSIONS
  Of RH patients, 30.3 % were not eligible for bilateral RDN with the current Simplicity Flex catheter. This classification provides the basis for standardized reporting to allow for pooling of results of larger patient cohorts in the future.
authors.affiliation: Department of Cardiovascular and Interventional Radiology, Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, 75015, Paris, France, okabone@gmail.com.
authors.forename: Takuya
authors.initials: T
authors.lastname: Okada
authors.forename: Olivier
authors.initials: O
authors.lastname: Pellerin
authors.forename: Sébastien
authors.initials: S
authors.lastname: Savard
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Curis
authors.forename: Matthieu
authors.initials: M
authors.lastname: Monge
authors.forename: Michael
authors.initials: M
authors.lastname: Frank
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bobrie
authors.forename: Masato
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Koji
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Pierre-François
authors.initials: PF
authors.lastname: Plouin
authors.forename: Michel
authors.initials: M
authors.lastname: Azizi
authors.forename: Marc
authors.initials: M
authors.lastname: Sapoval
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003714:Denervation; D004351:Drug Resistance; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging*; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000294:innervation*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D003287:Contrast Media; C093233:iobitridol; D007472:Iohexol