title: Safety and Feasibility of Renal Sympathetic Denervation in Patients With Insufficient Renal Artery Length.
abstract: Insufficient renal artery length for renal sympathetic denervation (RDN) is defined as having a main renal artery shorter than 20 mm in length. Such an anatomy is considered a contraindication for most of the currently available endovascular RDN devices. The concern stems from the need to distribute the ablation points to effect circumferential ablation causing sympathetic denervation, without the risk of injuring the renal artery. We postulate that if the requisite ablation points could be distributed between large caliber renal branches and the short main renal artery, RDN is likely feasible and safe. We demonstrate this with 2 cases using 2 different RDN devices and detail the technical feasibility.
authors.affiliation: Tan Tock Seng, Tock Seng, Singapore druei@yahoo.com.
authors.forename: Uei
authors.initials: U
authors.lastname: Pua
authors.affiliation: Vascular & Interventional Radiology Centre, Subang Jaya Medical Centre, Selangor Darulehsan, Malaysia.
authors.forename: Alex Ah Lak
authors.initials: AA
authors.lastname: Tang
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Yau Wei
authors.initials: YW
authors.lastname: Ooi
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Hee Hwa
authors.initials: HH
authors.lastname: Ho
authors.affiliation: Department of Cardiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Paul Jau Leong
authors.initials: PJ
authors.lastname: Ong
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D001027:Aortography; D001794:Blood Pressure / Q000187:drug effects; D004351:Drug Resistance; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000098:blood supply*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011237:Predictive Value of Tests; D012077:Renal Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000294:innervation*; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome; D054079:Vascular Malformations / Q000150:complications* / Q000000981:diagnostic imaging
chemical_list: D000959:Antihypertensive Agents
keywords: denervation; renal; sympathetic