title: Renal artery and parenchymal changes after renal denervation: assessment by magnetic resonance angiography.
abstract: OBJECTIVE
  Relatively little is known about the incidence of long-term renal damage after renal denervation (RDN), a potential new treatment for hypertension. In this study the incidence of renal artery and parenchymal changes, assessed with contrast-enhanced magnetic resonance angiography (MRA) after RDN, is investigated.
  
  
  METHODS
  This study is an initiative of ENCOReD, a collaboration of hypertension expert centres. Patients in whom an MRA was performed before and after RDN were included. Scans were evaluated by two independent, blinded radiologists. Primary outcome was the change in renal artery morphology and parenchyma.
  
  
  RESULTS
  MRAs from 96 patients were analysed. Before RDN, 41 renal anomalies were observed, of which 29 mostly mild renal artery stenoses. After a median time of 366 days post RDN, MRA showed a new stenosis (25-49% lumen reduction) in two patients and progression of pre-existing lumen reduction in a single patient. No other renal changes were observed and renal function remained stable.
  
  
  CONCLUSIONS
  We observed new or progressed renal artery stenosis in three out of 96 patients, after a median time of 12 months post RDN (3.1%). Procedural angiographies showed that ablations were applied near the observed stenosis in only one of the three patients.
  
  
  CONCLUSIONS
  • The incidence of vascular changes 12 months post RDN was 3.1%. • No renal vascular or parenchymal changes other than stenoses were observed. • Ablations were applied near the stenosis in only one of three patients.
authors.affiliation: Department of Nephrology and Hypertension, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
authors.forename: Margreet F
authors.initials: MF
authors.lastname: Sanders
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Pieter Jan
authors.initials: PJ
authors.lastname: van Doormaal
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Martine M A
authors.initials: MMA
authors.lastname: Beeftink
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.affiliation: Department of Internal Medicine and Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway.
authors.forename: Fadl Elmula M
authors.initials: FEM
authors.lastname: Fadl Elmula
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Jesse
authors.initials: J
authors.lastname: Habets
authors.affiliation: Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Hammer
authors.affiliation: Section for Interventional Cardiology, Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway.
authors.forename: Pavel
authors.initials: P
authors.lastname: Hoffmann
authors.affiliation: Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Lotte
authors.initials: L
authors.lastname: Jacobs
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK.
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Mark
authors.affiliation: Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.|Cardiology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Persu
authors.affiliation: Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium.|Cardiology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Jean
authors.initials: J
authors.lastname: Renkin
authors.affiliation: Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK.
authors.forename: Giles
authors.initials: G
authors.lastname: Roditi
authors.affiliation: Department of Vascular Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Wilko
authors.initials: W
authors.lastname: Spiering
authors.affiliation: Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Staessen
authors.affiliation: Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland, UK.
authors.forename: Alison H
authors.initials: AH
authors.lastname: Taylor
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Willemien L
authors.initials: WL
authors.lastname: Verloop
authors.affiliation: Department of Nephrology and Hypertension, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
authors.forename: Eva E
authors.initials: EE
authors.lastname: Vink
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Evert-Jan
authors.initials: EJ
authors.lastname: Vonken
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Michiel
authors.initials: M
authors.lastname: Voskuil
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Leiner
authors.affiliation: Department of Nephrology and Hypertension, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands. p.j.blankestijn@umcutrecht.nl.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Blankestijn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000473:pathology / Q000601:surgery; D007668:Kidney / Q000294:innervation / Q000473:pathology; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D012077:Renal Artery / Q000473:pathology*; D012078:Renal Artery Obstruction / Q000473:pathology*; D013562:Sympathectomy / Q000009:adverse effects* / Q000379:methods
keywords: Hypertension; Magnetic resonance angiography; Renal artery stenosis; Renal denervation; Vascular changes