Does Renal Artery Supply Indicate Treatment Success of Renal Denervation?

作者：Schmid Axel^*; Ditting Tilmann; Sobotka Paul A; Veelken Roland; Schmieder Roland E; Uder Michael; Ott Christian

来源：CardioVascular and Interventional Radiology, 2013, 36(4): 987-991.

DOI：10.1007/s00270-013-0652-9

• Ablation
• Artery
• Endovascular treatment
• Hypertension
• Kidney/renal
• Radiofrequency ablation

Renal denervation (RDN) emerged as an innovative interventional antihypertensive therapy. With the exception of pretreatment blood pressure (BP) level, no other clear predictor for treatment efficacy is yet known. We analyzed whether the presence of multiple renal arteries has an impact on BP reduction after RDN.
Fifty-three patients with treatment-resistant hypertension (office BP a parts per thousand yen 140/90 mmHg and 24-h ambulatory BP monitoring (a parts per thousand yen130/80 mmHg) underwent bilateral catheter-based RDN. Patients were stratified into one-vessel (OV) (both sides) and at least multivessel (MV) supply at one side. Both groups were treated on one vessel at each side; in case of multiple arteries, only the dominant artery was treated on each side.
Baseline clinical characteristics (including BP, age, and estimated glomerular filtration rate) did not differ between patients with OV (n = 32) and MV (n = 21). Office BP was significantly reduced in both groups at 3 months (systolic: OV -15 +/- A 23 vs. MV -16 +/- A 20 mmHg; diastolic: OV -10 +/- A 12 vs. MV -8 +/- A 11 mmHg, both p = NS) as well as 6 months (systolic: OV -18 +/- A 18 vs. MV -17 +/- A 22 mmHg; diastolic: OV -10 +/- A 10 vs. -10 +/- A 12 mmHg, both p = NS) after RDN. There was no difference in responder rate (rate of patients with office systolic BP reduction of at least 10 mmHg after 6 months) between the groups.
In patients with multiple renal arteries, RDN of one renal artery-namely, the dominant one-is sufficient to induce BP reduction in treatment-resistant hypertension.

• 出版日期2013-8