Renal Denervation Using an Irrigated Catheter in Patients with Resistant Hypertension: A Promising Strategy?

作者：Luciana Armaganijan, Rodolfo Staico, Aline Alexandra Iannoni de Moraes, Alexandre Abizaid, Dalmo Antônio Ribeiro Moreira, Celso Amodeo, Márcio Gonçalves de Sousa, Flavio Antonio de Oliveira Borelli, Dikran Armaganijan, José Eduardo Sousa, Amanda G.M.R. Sousa · 发表于：Arquivos Brasileiros de Cardiologia · 年份：2014 · DOI：10.5935/abc.20140034 · 被引用次数：16 · 研究领域：Renal and Vascular Pathologies、Blood Pressure and Hypertension Studies、Acute Kidney Injury Research

BACKGROUND: Systemic hypertension is an important public health problem and a significant cause of cardiovascular mortality. Its high prevalence and the low rates of blood pressure control have resulted in the search for alternative therapeutic strategies. Percutaneous renal sympathetic denervation emerged as a perspective in the treatment of patients with resistant hypertension. OBJECTIVE: To evaluate the feasibility and safety of renal denervation using an irrigated catheter. METHODS: Ten patients with resistant hypertension underwent the procedure. The primary endpoint was safety, as assessed by periprocedural adverse events, renal function and renal vascular abnormalities at 6 months. The secondary endpoints were changes in blood pressure levels (office and ambulatory monitoring) and in the number of antihypertensive drugs at 6 months. RESULTS: The mean age was 47.3 (± 12) years, and 90% of patients were women. In the first case, renal artery dissection occurred as a result of trauma due to the long sheath; no further cases were observed after technical adjustments, thus showing an effect of the learning curve. No cases of thrombosis/renal infarction or death were reported. Elevation of serum creatinine levels was not observed during follow-up. At 6 months, one case of significant renal artery stenosis with no clinical consequences was diagnosed. Renal denervation reduced office blood pressure levels by 14.6/6.6 mmHg, on average (p = 0.4 both for systolic and diastolic bl...