Intoduction:
Although radiofrequency renal denervation (RF-RND) may cause acute spasm, intimal injury and thrombus formation, there are no data on long-term renal artery (RA) healing.
Hypothesis:
Aim of this study was to assess the RA healing after RF-RND by optical coherence tomography (OCT) imaging and quantitative contrast angiography (QCA) at long-term follow-up.
Methods:
A single center registry enrolled 12 patients (22 RA) with refractory hypertension previously treated with RF-RND (Symplicity, Medtronic). Imaging studies (QCA and OCT) were done at (mean±SD) 18.41±5.83 months after RF-RND.
Results:
No adverse events or complications were noted during the follow-up. Ten patients (83%) achieved significant reductions of blood pressure by ≥10 mmHg on 4.50 ± 1.08 medications per patient. OCT analysis involved 518 mm of pullbacks and 518 cross-sections. There were 26 spots of focal intimal thickening found in 10 (83%) patients in 14 (64%) arteries and calcifications in 2 (9%) of treated RA. The mean area of focal intimal thickening was 0.054±0.033 mm2 and it was limited to the intimal layer. No vessel dissection, thrombus, intimal tear or acute vasospasms were observed during the OCT analysis. The QCA revealed that minimal lumen and proximal lumen diameter were smaller after the RND and this difference was persistent at follow-up, as compared to measurements obtained before RND [6.21±1.01 vs. 5.61 ± 0.60, p=0.005 and 5.53±0.99 vs. 5.15±0.67, p=0.034, respectively].
Conclusions:
There is a favorable long-term vessel healing after RF-RND without significant RA stenosis. Only focal intimal thickening and a modest reduction of the minimal lumen diameter may be observed in long-term and their relation to the RND procedure needs further studies.
Long-Term Follow-Up Evaluation After Sirolimus-Eluting Stent Implantation by Optical Coherence Tomography
