Renal Artery Stenosis After Renal Sympathetic Denervation

Kaltenbach, Benjamin; Id, Dani; Franke, Jennifer; Sievert, Horst; Hennersdorf, M.; Maier, Janina; Bertog, Stefan

doi:10.1016/j.jacc.2012.09.027

Cited by 134 publications

(67 citation statements)

References 6 publications

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“…Overall, our results are consistent with the likewise very low rate of complications reported in previously published studies [10,11,17,19]. However, it should be noted that de novo renal artery stenosis following renal denervation has been reported [21,22]. The small patient cohort is a limitation of the present study.…”

Section: Discussionsupporting

confidence: 92%

Renal Denervation: Results of a Single-Center Cohort Study

Luetkens

Wilhelm

Düsing

et al. 2014

Fortschr Röntgenstr

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Purpose: To investigate the effect of renal denervation on office-based and 24-h ambulatory blood pressure measurements (ABPM) in a highly selective patient population with drug-resistant hypertension. Materials and Methods: Patients with drug resistant hypertension eligible for renal denervation were included in the study population. Office blood pressure and ABPM were assessed prior to and after renal denervation. To detect procedure related renal or renal artery damage, magnetic resonance imaging (MRI) and angiography (MRA) were performed pre-interventional, one day post-interventional, and one month after renal denervation. Results: Mean follow-up time between renal denervation and blood pressure re-assessment was 9.5???3.9 months. Between August 2011 and March 2013, 17 patients prospectively underwent renal denervation. Pre-interventional mean office blood pressure and ABPM were 177.3???20.3/103.8???20.4?mmHg and 155.2???20.5/93.7???14.5?mmHg, respectively. Post-interventional, office blood pressure was significantly reduced to 144.7???14.9/89.5???12.1 (p??0.05). The number of prescribed antihypertensive drugs was unchanged after renal denervation (4.7???2.0 vs. 4.2???1.2, p?=?0.18). No renovascular complications were detected in follow-up MRI. Conclusion: After renal denervation, no significant decrease in ABPM was observed. These results may indicate a limited impact of renal denervation for drug resistant hypertension. Key Points: ??Renal denervation showed no significant effects on 24-h ambulatory blood pressure measurements. ??A significant decrease in office blood pressure measurements may be explained by a potential detection bias. ??Renal artery alterations were not observed on follow-up MRI scans. Citation Format: ??Luetkens J. A., Wilhelm K., D?sing R. et?al. Renal Denervation: Results of a Single-Center Cohort Study. Fortschr R?ntgenstr 2015; 187: 36???41

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Section: Discussionsupporting

confidence: 92%

Renal Denervation: Results of a Single-Center Cohort Study

Luetkens

Wilhelm

Düsing

et al. 2014

Fortschr Röntgenstr

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“…Review of a renal sympathetic denervation registry identified one patient with pre-existent mild renal artery stenosis in a location remote from radiofrequency application that progressed to a hemodynamically significant stenosis at six months requiring renal artery stenting (19). Though the overall incidence of this complication appears to be low, it is noteworthy that there are two reports of renal artery stenoses that developed at ablation sites (25,26) and that, due to the frequent inconsistent follow-up and absence of long-term data, a final conclusion regarding this risk cannot yet be made.…”

Section: Study Limitationsmentioning

confidence: 98%

Renal denervation

Drexel¹,

Bertog²,

Vaškelytė³

et al. 2014

Anadolu Kardiyol Derg

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Severe hypertension, resistant to conventional antihypertensive medications, is associated with major adverse cardiovascular and cerebrovascular events and renal insufficiency. Renal sympathetic nerve over-activity frequently accompanies essential hypertension. Catheter-based renal sympathetic denervation leads to a reduction in renal and overall sympathetic nerve activity and improvement in blood pressure in the setting of severe resistant hypertension. In the following, we review the role of the renal sympathetic nervous system in blood pressure control and recent clinical experience with renal denervation. Furthermore, potential beneficial effects on diabetes control, obstructive sleep apnea, atrial and ventricular arrhythmias are discussed. (Anadolu Kardiyol Derg 2014; 14: 186-91)

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“…Two cases of renal artery stenosis following RSD with RF raised some concerns about its possible causal role. 3, 4 Two cases of progression of a pre-existing renal artery stenosis were described in the Symplicity HTN-1 and Symplicity HTN-2 studies. 5, 6 In the present case, the short time interval (3 months) and the comparison of the pre-and post-procedural angiographic findings supports a causal role for RF ablation in renal artery stenosis progression.…”

Section: Disclosuresmentioning

confidence: 99%