Renal ablation for treatment of hypertension without Symplicity catheter: The first human experience

• Main Authors: Mehrdad Honarvar, Afshin Amirpour, Masoud Pourmoghaddas
• Format: Article
• Language: English
• Published: Vesnu Publications 2013-03-01
• Series: ARYA Atherosclerosis
• Online Access: http://arya.mui.ac.ir/index.php/arya/article/view/505

<div><p class="abstract"><strong>BACKGROUND:</strong> Hypertension (HTN) treatment has remained insufficient. New modalities such as &ldquo;Symplicity method&rdquo; for the treatment of HTN are a priority, especially in patients with resistant hypertension. In this study, we describe our first experience with a novel percutaneous treatment modality, without using Symplicity catheter.</p> <p class="abstract"><strong>METHODS:</strong> 30 Patients who were resistant to at least three types of antihypertensive medical therapy were selected. Patients received percutaneous renal artery denervation, without Symplicity catheter method, and were followed up for 1 week, 1, 3, and 6 months later after treatment. Ambulatory 24-hour blood pressure (BP) Holter was performed 1 week before intervention and after 1 month. The primary outcome was change in 24-hour ambulatory BP and change in office and home-based BP measurements.</p> <p class="abstract"><strong>RESULTS:</strong><strong> </strong>The mean age of the studied patients was 52 &plusmn; 15.4 years and 43.3% (n = 13) were female. Systolic and diastolic BP at baseline was 163 &plusmn; 17.2 and 95 &plusmn; 8.2 mmHg, respectively. Patients took 3.6 &plusmn; 1.3 hypertensive medications. Systolic and diastolic BP at 1-week, 1-month, 3-month and 6-month after renal denervation significantly decreased compared to the baseline (P &lt; 0.0001). Average BP derived from 24-hour ambulatory BP monitoring changed in parallel with office-based BP measurements. Most of patients (50%) who underwent renal denervation had reductions of 10 mmHg or greater in systolic BP and 56.7% of them had reductions of 5 mmHg or greater in diastolic BP. 33.3% of patients also achieved the target of systolic BP less than 140 mmHg and 60% achieved the target of diastolic BP less than 90 mmHg. No patients showed vascular damage at final angiography.</p> <p class="abstract"><strong>CONCLUSION:</strong> Catheter based renal ablation was associated with a significant reduction in both systolic and diastolic BP, on top of maximal medical therapy, which persisted throughout 6 months follow-up in the first-in-man study without the Symplicity catheter.</p> <p class="abstract">&nbsp;</p> <p class="abstract"><strong>Keywords:</strong> Renal Denervation, Resistant Hypertension, Catheter</p></div>