Vol 71, No 2 (2013)
Original articles
Published online: 2013-02-19
Denervation (ablation) of nerve terminalis in renal arteries: early results of interventional treatment of arterial hypertension in Poland
DOI: 10.5603/KP.2013.0008
Kardiol Pol 2013;71(2):152-158.
Abstract
Background: Arterial hypertension is one of the main causes of cardiovascular disease morbidity and overall mortality.
Aim: To report the single centre experiences with changes in arterial blood pressure (BP) in patients after intra-arterial application
of radiofrequency (RF) energy to cause renal sympathetic efferent and somatic afferent nerve and report vascular
and kidney safety in a six month follow up.
Methods: Twenty-eight patients, with hypertension despite medical therapy (median age 52.02 years, range 42–72 years)
consented to therapeutic renal nerve ablation. SIMPLICITY RF catheters and generator provided by Ardian (currently Medtronic
Inc., USA) were used to perform renal artery angiography and ablation.
Results: The mean BP at baseline, and after one month, three months and six months were measured [mm Hg]: systolic
176.6; 162.3 (p = 0.004); 150.6 (p < 0.001); 147.2 (p < 0.001); diastolic 100.2; 90.3 (p < 0.001); 91.79 (p = 0.03);
88.5 (p < 0.001); pulse pressure 76.57; 75.18 (p = NS); 65.80 (p < 0.001); 62.15 (p < 0.001). Neither procedure-related
nor therapy-related complications were reported in the six month follow up.
Conclusions: In our cohort of patients, intra-arterial renal nerve denervation was not associated with either vascular or renal
complications out to six months. Nerve ablation of renal arteries led to significant reduction of mean values of arterial systolic,
diastolic BP and significant reduction of pulse pressure. The Polish experience is not significantly different compared to that
reported in the Symplicity I and Symplicity II international cohorts. The long term durability of this therapy and its application
to earlier stages of hypertension or other disease states will require further investigation.
Aim: To report the single centre experiences with changes in arterial blood pressure (BP) in patients after intra-arterial application
of radiofrequency (RF) energy to cause renal sympathetic efferent and somatic afferent nerve and report vascular
and kidney safety in a six month follow up.
Methods: Twenty-eight patients, with hypertension despite medical therapy (median age 52.02 years, range 42–72 years)
consented to therapeutic renal nerve ablation. SIMPLICITY RF catheters and generator provided by Ardian (currently Medtronic
Inc., USA) were used to perform renal artery angiography and ablation.
Results: The mean BP at baseline, and after one month, three months and six months were measured [mm Hg]: systolic
176.6; 162.3 (p = 0.004); 150.6 (p < 0.001); 147.2 (p < 0.001); diastolic 100.2; 90.3 (p < 0.001); 91.79 (p = 0.03);
88.5 (p < 0.001); pulse pressure 76.57; 75.18 (p = NS); 65.80 (p < 0.001); 62.15 (p < 0.001). Neither procedure-related
nor therapy-related complications were reported in the six month follow up.
Conclusions: In our cohort of patients, intra-arterial renal nerve denervation was not associated with either vascular or renal
complications out to six months. Nerve ablation of renal arteries led to significant reduction of mean values of arterial systolic,
diastolic BP and significant reduction of pulse pressure. The Polish experience is not significantly different compared to that
reported in the Symplicity I and Symplicity II international cohorts. The long term durability of this therapy and its application
to earlier stages of hypertension or other disease states will require further investigation.
Keywords: arterial hypertensionrenal related hypertensionresistant hypertensionrenal arteries ablation
