title: Procedural Reassessment of Radiofrequency Renal Denervation in Resistant Hypertensive Patients.
abstract: BACKGROUND
  Recent anatomical and clinical studies have led to the hypothesis that in several cases of failure of response to renal denervation (RDN), the procedure has not been technically correct.
  
  
  OBJECTIVE
  To perform procedural reassessment in patients with true resistant hypertension who underwent RDN.
  
  
  METHODS
  We retrospectively reassessed the procedural technique of RDN in 10 true resistant hypertensive patients, comparing the sites of renal ablations with the knowledge of animal and human post mortem evidences. Procedural ablation technique was assessed in terms of number of ablations for each renal artery and site of ablation (quadrant and distance from renal ostium) by using the radiologic images of each RDN and the number of radiofrequency ablation attempts documented in the reports of each denervation session.
  
  
  RESULTS
  10 patients were studied, 9 denervated with Simplicity monoelectrode catheter, 1 with multielectrode balloon technique. Responders to the procedure underwent more ablations and particularly at least a quadrant ablation in one of the kidney arteries, >2 ablations in Dorsal plus Ventral quadrants and in 67% of then >10 ablations were done in superior inferior and ventral quadrants.
  
  
  CONCLUSIONS
  This study confirms the importance of a well knowledge of renal artery anatomy and underlines the relevance of the choice of ablation sites in order to obtain a successful RDN procedure.
authors.affiliation: Hypertension Unit AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Rabbia
authors.affiliation: Internal Medicine, Ospedale Santa Croce e Carle, Cuneo, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Testa
authors.affiliation: Hypertension Unit AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy. chiara.fulcheri@gmail.com.
authors.forename: Chiara
authors.initials: C
authors.lastname: Fulcheri
authors.affiliation: Hypertension Unit AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Berra
authors.affiliation: Hypertension Unit AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Di Monaco
authors.affiliation: Hypertension Unit AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Covella
authors.affiliation: Hypertension Unit AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pappaccogli
authors.affiliation: Hypertension Unit AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Monticone
authors.affiliation: Hemodynamic Laboratory, Cardio-Thoracic-Vascular Department, Azienda Ospedaliera "Carlo Poma", Mantua, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: Rosiello
authors.affiliation: Radiology Unit AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Turin, Italy.
authors.forename: Denis
authors.initials: D
authors.lastname: Rossato
authors.affiliation: Hypertension Unit AOU Città della Salute e della Scienza, Department of Medical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Veglio
mesh_terms: D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D017115:Catheter Ablation / Q000009:adverse effects; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D007668:Kidney / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000294:innervation*; D012189:Retrospective Studies; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods*; D013564:Sympathetic Nervous System / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: Invasive therapy; Renal artery; Renal sympathetic denervation; Resistant hypertension