Impact of local vascular lesions assessed with optical coherence tomography and ablation points on blood pressure reduction after renal denervation

Ghadri, Jelena-Rima; Gaehwiler, Roman; Jaguszewski, Miłosz; Sudano, Isabella; Osipova, Julia; Schoenenberger-Berzins, Renate; Erné, Paul; Lüscher, Thomas F.; Templin, Christian

doi:10.4414/smw.2015.14102

Cited by 6 publications

(5 citation statements)

References 25 publications

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“…Nevertheless, the problems associated with this procedure should not be ignored. Currently, although the number of patients who undergo percutaneous endovascular RDN is limited and the follow-up period is short, some side effects have been reported [15], i.e., lumen stenosis, atrial wall hematoma, intimal tears, intraluminal thrombosis, intima-media thickening [16][17][18][19], etc. Most of these factors may be caused by the direct delivery of RF energy or stimulation of the endothelium by the wire and catheter.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic-based perivascular renal sympathetic nerve denervation: a feasibility study in a porcine model

Zhao

Yang

et al. 2020

Eur J Med Res

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Background: This study aims to evaluate the effects and safety of laparoscopic-based perivascular renal sympathetic nerve denervation (RDN) in a porcine model fed a high-fat diet. Method: Thirty-six high-fat diet-fed Bama minipigs were randomly divided into an RDN group (n = 18), in which minipigs received laparoscopic-based perivascular RDN, and a sham group (n = 18). All pigs were fed the high-fat diet after the operation to establish a model of obesity-induced hypertension. Bama pigs in the RDN and sham groups were killed at 3 time points [2 days after RDN (n = 6), day 90 (n = 6) and day 180 (n = 6)]. Result: The systolic blood pressure (SBP) and noradrenaline (NE) concentration in the kidney tissue were significantly lower in the RDN group than in the sham group at 2 days (113.83 ± 3.26 mmHg vs 129.67 ± 3.32 mmHg, P = 0.011, and 112.02 ± 17.34 ng/g vs 268.48 ± 20.61 ng/g, P < 0.001, respectively), 90 days (116.83 ± 3.88 mmHg vs 145.00 ± 4.22 mmHg, P = 0.001, respectively) and 180 days (129.33 ± 2.87 mmHg vs 168.57 ± 2.86 mmHg, P < 0.001, and 152.15 ± 16.61 ng/g vs 318.97 ± 24.84 ng/g, P < 0.001, respectively) after the operation. The diastolic blood pressure (DBP) was significantly lower in the RDN group than in sham group at 90 and 180 days after the operation (72.17 ± 2.7 mmHg vs 81.50 ± 2.22 mmHg, P = 0.037, and 76.83 ± 2.75 mmHg vs 86.33 ± 2.22 mmHg P = 0.021, respectively). Based on the pathological evaluation, the renal sympathetic nerve fascicles were successfully disrupted by radiofrequency energy after laparoscopic-based perivascular RDN, but the intima was intact. Tyrosine hydroxylase (TH) expression was decreased, while the expression of the S100 protein was increased in treated renal arteries after RDN. Conclusions: Laparoscopic-based perivascular RDN prevented the occurrence and development of hypertension, and thus it may be an efficient and safe method for controlling blood pressure in an experimental model.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic-based perivascular renal sympathetic nerve denervation: a feasibility study in a porcine model

Zhao

Yang

et al. 2020

Eur J Med Res

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“…Ablation Sites. As is reported in previous studies, the number of ablation sites in each renal artery has been considered as a major influence factor for prediction of office SBP [24,64], rather than 24 h-ABPM [13,64,65] after RDN. Furthermore, ablations at different segments of renal artery are also confounding factors affecting the outcome of RDN.…”

Section: Procedural Factorsmentioning

confidence: 94%

Present Evidence of Determinants to Predict the Efficacy of Renal Denervation

Zhou

Chen

et al. 2022

International Journal of Hypertension

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Sympathetic overactivation is one of the main contributors to development and progress of hypertension. Renal denervation (RDN) has been evidenced by series of clinical trials for its efficacy and safety to treat overactivated sympathetic nervous system induced diseases. However, the results were inconsistent and not all patients benefited from RDN. Appropriate patient selection and intraoperative factors to improve the efficacy of RDN need to be solved urgently. Over the decade, research studies on the correlations between indicators and the antihypertensive effects have been conducted and made a fairly well progress. Herein, we comprehensively reviewed the research studies on how to make RDN more predictable or improve the efficacy of RDN and summarized these potential indicators or devices which might be applied in clinical settings.

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“…This study also confirmed that short-and long-term side effects of sympathetic renal denervation are minimal. 37,45,58,59 The important insights provided by the Symplicity HTN3 and DENERHTN studies J U…”

Section: Catheter-based Renal Nerve Denervationmentioning

confidence: 99%

Interventional therapy for hypertension: Back on track again?

Erné

Sudano

Resink

et al. 2016

Critical Reviews in Clinical Laboratory Sciences

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Treatment-resistant hypertension, or resistant hypertension, is defined as blood pressure that remains above target despite concurrent use of at least three antihypertensive agents from different classes at optimal doses, one of which should be a diuretic. Important considerations in the diagnosis of treatment-resistant hypertension include the exclusion of pseudoresistance and the evaluation of potential secondary causes of hypertension and of concomitant conditions that maintain high blood pressure. The ability to diagnose true treatment-resistant hypertension is important for selection of patients who may be appropriately treated with an invasive therapy. Currently, there are three interventional approaches to treat resistant hypertension, namely: (1) reduction of the activity of the sympathetic nervous system by renal nerve ablation, (2) stimulation of baroreceptors and (3) creation of a peripheral arterial venous anastomosis. This review focuses on the rationale behind these invasive approaches and the clinical results.

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Impact of local vascular lesions assessed with optical coherence tomography and ablation points on blood pressure reduction after renal denervation

Abstract: Our study demonstrates for the first time that the number and type of vascular lesions as assessed with OCT did not predict the success of BP reduction after RDN. However, we observed a substantial decrease in office SBP in relation to the number of ablation points at 6 months.

Cited by 6 publications

References 25 publications

Laparoscopic-based perivascular renal sympathetic nerve denervation: a feasibility study in a porcine model

Laparoscopic-based perivascular renal sympathetic nerve denervation: a feasibility study in a porcine model

Present Evidence of Determinants to Predict the Efficacy of Renal Denervation

Interventional therapy for hypertension: Back on track again?

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