TCT-12 Long-term Follow-up of Catheter-based Renal Denervation For Resistant Hypertension Confirms Durable Blood Pressure Reduction

AbstractIncreasing studies strongly prove that renal denervation, a minimally invasive surgery, is a promising new non-drug treatment method that can effectively control blood pressure in patients with resistant hypertension, but the evaluation of the long-term blood pressure control effect of renal denervation for resistant hypertension is still lacking. Here, we critically review current long-term follow-up data about the use of renal denervation for RH to comprehensively evaluate the effectiveness of renal denervation for RH, and to provide practical guidance for practitioners who are establishing a renal denervation service. Limited by the current research, many problems need to be solved before renal denervation is applied to RH. In addition, ambulatory blood pressure should be the first choice for the evaluation of blood pressure. Finally, the continuous antihypertensive effect of renal denervation in different renal denervation systems also needs to be strictly compared.

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Long-term benefit of renal denervation on blood pressure control in a patient with hemorrhagic stroke

SAGE Open Medical Case Reports ◽

10.1177/2050313x19870972 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1987097

Author(s):

Francesco Versaci ◽

Giuseppe Andò ◽

Marcello Chiocchi ◽

Francesco Romeo

Keyword(s):

Blood Pressure ◽

Renal Denervation ◽

Hemorrhagic Stroke ◽

Blood Pressure Reduction ◽

Pressure Control ◽

Refractory Hypertension ◽

Sustained Efficacy ◽

Term Benefit

A 49-year-old man with malignant hypertension had been admitted with hemorrhagic stroke. Refractory hypertension had been observed during hospitalization and the decision had been made to perform renal denervation. A significant blood pressure reduction was obtained immediately after renal denervation and persists at 2-year follow-up. This case demonstrates the long-term sustained efficacy of renal denervation performed in the acute phase of hemorrhagic stroke. In addition, it supports the notion that renal denervation–induced normalization of blood pressure may contribute to better outcomes in a challenging setting such as intracranial bleeding.

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THE EFFECTS OF TRANSCATHETER RENAL DENERVATION ON BLOOD PRESSURE AND BRAIN STRUCTURAL CHANGES IN RESISTANT HYPERTENSION

Arterial’naya Gipertenziya (Arterial Hypertension) ◽

10.18705/1607-419x-2013-19-3-256-262 ◽

2013 ◽

Vol 19 (3) ◽

pp. 256-262 ◽

Cited By ~ 2

Author(s):

N. L. Afanasieva ◽

S. E. Pekarskiy ◽

V. F. Mordovin ◽

G. V. Semke ◽

T. M. Ripp ◽

...

Keyword(s):

Blood Pressure ◽

Magnetic Resonance ◽

Resistant Hypertension ◽

Renal Denervation ◽

Single Case ◽

Blood Pressure Reduction ◽

Magnetic Resonance Tomography ◽

Lateral Ventricles ◽

The Brain

Objective.To study the changes of 24-hour blood pressure parameters and brain structure at follow-up after transcatheter renal denervation in resistant hypertension.Design and methods.We enrolled patients with verified resistant hypertension undergoing an intervention that included 4–8 applications of radiofrequency discharge in both renal arteries using a standard catheter5 F under the controlled temperature regimen (60 С0, 8 Watt, 2-minute application). The efficiency of the intervention was assessed by the office and 24-hour blood pressure decrease within 6 months after intervention. All subjects underwent magnetic resonance tomography («Magnetom-OPEN», «Siemens AG», Germany).Results.By the time of statistical analysis 45 subjects underwent renal denervation, there was not a single case of renal artery damage. At six-month follow-up a significant reduction of office blood pressure (-34,8/-17,2 mmHg; p < 0,00001/0,00001), and mean 24-hour blood pressure (-11,1/-7,1 mmHg; p < 0,001/0,001) was found. No increase of encephalopathy signs by magnetic resonance tomography was found. At the same time there was a reduction of the linear size of lateral ventricles of the brain, subarachnoid space, III ventricle of the brain, liquor volume in the lateral ventricles of the brain.Conclusions.Renal denervation is a safe method resulting in effective blood pressure reduction in resistant hypertension. It is associated with the positive changes of encephalopathy and liquor dynamics according to the magnetic resonance tomography.

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Acute on/off effects and chronic blood pressure reduction after long-term baroreflex activation therapy in resistant hypertension

Journal of Hypertension ◽

10.1097/hjh.0000000000000586 ◽

2015 ◽

Vol 33 (8) ◽

pp. 1697-1703 ◽

Cited By ~ 23

Author(s):

Marcel Halbach ◽

Tilman Hickethier ◽

Navid Madershahian ◽

Hannes Reuter ◽

Mathias C. Brandt ◽

...

Keyword(s):

Blood Pressure ◽

Resistant Hypertension ◽

Blood Pressure Reduction ◽

Pressure Reduction ◽

Baroreflex Activation Therapy ◽

Activation Therapy

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Catheter-based ultrasound renal denervation in patients with resistant hypertension: the randomized, controlled REQUIRE trial

Hypertension Research ◽

10.1038/s41440-021-00754-7 ◽

2021 ◽

Author(s):

Kazuomi Kario ◽

Yoshiaki Yokoi ◽

Keisuke Okamura ◽

Masahiko Fujihara ◽

Yukako Ogoyama ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Resistant Hypertension ◽

Renal Denervation ◽

Blood Pressure Reduction ◽

Control Group ◽

Pressure Reduction ◽

Sham Control ◽

Sham Procedure ◽

Significant Difference

Abstract Renal denervation is a promising new non-pharmacological treatment for resistant hypertension. However, there is a lack of data from Asian patients. The REQUIRE trial investigated the blood pressure-lowering efficacy of renal denervation in treated patients with resistant hypertension from Japan and South Korea. Adults with resistant hypertension (seated office blood pressure ≥150/90 mmHg and 24-hour ambulatory systolic blood pressure ≥140 mmHg) with suitable renal artery anatomy were randomized to ultrasound renal denervation or a sham procedure. The primary endpoint was change from baseline in 24-hour ambulatory systolic blood pressure at 3 months. A total of 143 patients were included (72 renal denervation, 71 sham control). Reduction from baseline in 24-hour ambulatory systolic blood pressure at 3 months was not significantly different between the renal denervation (−6.6 mmHg) and sham control (−6.5 mmHg) groups (difference: −0.1, 95% confidence interval −5.5, 5.3; p = 0.971). Reductions from baseline in home and office systolic blood pressure (differences: –1.8 mmHg [p = 0.488] and −2.0 mmHg [p = 0.511], respectively), and medication load, did not differ significantly between the two groups. The procedure-/device-related major adverse events was not seen. This study did not show a significant difference in ambulatory blood pressure reductions between renal denervation and a sham procedure in treated patients with resistant hypertension. Although blood pressure reduction after renal denervation was similar to other sham-controlled studies, the sham group in this study showed much greater reduction. This unexpected blood pressure reduction in the sham control group highlights study design issues that will be addressed in a new trial. Clinical trial registration NCT02918305 (http://www.clinicaltrials.gov).

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Main Renal Artery Plus Branch Ablation in the Treatment of Resistant Hypertension with Renal Denervation

Cardiovascular Innovations and Applications ◽

10.15212/cvia.2021.0024 ◽

2021 ◽

Author(s):

Zong-Jun Liu

Keyword(s):

Blood Pressure ◽

Renal Artery ◽

Resistant Hypertension ◽

Average Energy ◽

Office Blood Pressure ◽

Significant Difference ◽

Main Renal Artery ◽

Long Term Follow Up

Objective: To study the safety and efficacy of denervation of renal artery branches in the treatment of resistant hypertension.Methods: Sixty patients with resistant hypertension were enrolled. The patients were randomly assigned to the mainrenal artery plus branch ablation group or the main renal artery ablation group. The clinical data and operation-relatedparameters, including number of ablation points, temperature, and average energy, were recorded. Ambulatory bloodpressure were taken for all patients at the baseline and at 6 months after treatment. Office blood pressure was recordedbefore treatment and after treatment every 3 months for 2 years.Results: Sixty patients with resistant hypertension were enrolled in this study. There were 30 patients in each group.Angiography was performed after ablation. No renal artery complications, such as stenosis and dissection, occurredin the two groups. There was no significant difference in age, sex, BMI, comorbid disease, and medication betweenthe two groups (P > 0.05). The number of ablation points for the main renal artery plus branch ablation group wasgreater than that for the main renal artery ablation group. The office blood pressure and 24-hour blood pressure weresignificantly lower 6 months after treatment than before treatment in both groups (P < 0.05). Office blood pressure inthe main renal artery plus branch ablation group was lower than that in the main renal artery ablation group during the3–12-month follow-up period, with a statistical difference. However, as the follow-up time increased, the differencedisappeared.Conclusion: The results of this study show that main renal artery plus branch ablation is a safe interventional method,but there was no obvious advantage on long-term follow-up compared with only main renal artery ablation.

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