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Neth Heart J. 2011 Aug;19(7-8):319-23. doi: 10.1007/s12471-011-0143-z.

Percutaneous renal denervation for the treatment of resistant essential hypertension; the first Dutch experience.

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  • 1Department of Cardiology, University Medical Center Utrecht, Room E.01.207, Heidelberglaan 100, 3584 CX, Utrecht, the Netherlands, m.voskuil@umcutrecht.nl.

Abstract

BACKGROUND:

In a subpopulation of patients with essential hypertension, therapeutic targets are not met, despite the use of multiple types of medication. In this paper we describe our first experience with a novel percutaneous treatment modality using renal artery radiofrequency (RF) ablation.

METHODS:

Patients who were resistant to at least three types of antihypertensive medical therapy (office systolic blood pressure ≥ 160 mmHg; n = 9) or who did not tolerate medication (n = 2) were selected. Between July and November 2010, a total of 11 patients received percutaneous RF treatment. Patients were followed up for 1 month after treatment. Urine and blood samples were taken to evaluate the effects on renal function and neurohumeral factors.

RESULTS:

No periprocedural complications or adverse events during follow-up were noted. A reduction of mean office blood pressure was seen from 203/109 ± 32/19 mmHg at baseline to 178/97 ± 28/21 mmHg at 1 month follow-up (mean difference 25 ± 12 mmHg, p < 0.01). Also, we noted a significant decrease in aldosterone level (391 ± 210 pmol/L versus 250 ± 142 pmol/L; p = 0.03), while there was no decrease in plasma renin activity (190 ± 134 fmol/L/s versus 195 ± 163 fmol/L/s; p = 0.43). No change in renal function was noted.

CONCLUSION:

Catheter-based renal denervation seems an attractive novel minimally invasive treatment option in patients with resistant hypertension, with a low risk of serious adverse events.

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