TCT- 402 Renal Norepinephrine Reduction Following Radiofrequency Renal Denervation Correlates with Extent of Nerve Ablation: Roles of Ablation Areas, Anatomy, and Number of Treatments

Arterial microanatomy determines the success of energy-based renal denervation in controlling hypertension

“…The smooth dependence of BP reduction on the number of degenerative nerves contrasts with the sharp, threshold-like dependence of renal NEPI levels on the fraction of affected nerves (13,33), degenerative or necrotic, suggesting that BP is not solely determined by NEPI concentration. Thus, although NEPI tracks with histologically apparent sympathetic denervation (13,33), BP may be sensitive to particular types of nerve disruptions or changes in afferent signaling. Indeed, recently published data (34) show that reductions in BP after RDN in patients with drug-resistant hypertension did not correlate tightly with sympathetic activity, as measured by single fiber nerve firing rates.…”

Transcatheter Renal Sympathetic Denervation: Chasing a Chimera or a Matter of Technological Improvements?

“…Renal noradrenaline reduction is closely related to the number of injured renal sympathetic nerves. It has been shown that renal noradrenaline concentration remained practically unaffected when 35% of sympathetic nerves were injured, while a gradual significant reduction (up to 75%) was observed when 70% of renal nerves were ablated [10]. In another experimental study using ultrasound instead of radiofrequency energy it was found that the injury of 75% of renal sympathetic nerves was accompanied by a 90% reduction of renal noradrenaline levels [11].…”