Format

Send to

Choose Destination
Cardiovasc Intervent Radiol. 2015 Feb;38(1):79-87. doi: 10.1007/s00270-014-0865-6. Epub 2014 Mar 6.

Eligibility for renal denervation: anatomical classification and results in essential resistant hypertension.

Author information

1
Department of Cardiovascular and Interventional Radiology, Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, 75015, Paris, France, okabone@gmail.com.

Abstract

PURPOSE:

To classify the renal artery (RA) anatomy based on specific requirements for endovascular renal artery denervation (RDN) in patients with drug-resistant hypertension (RH).

MATERIALS AND METHODS:

The RA anatomy of 122 consecutive RH patients was evaluated by computed tomography angiography and classified as two types: A (main RA ≥20 mm in length and ≥4.0 mm in diameter) or B (main RA <20 mm in length or main RA <4.0 mm in diameter). The A type included three subtypes: A1 (without accessory RAs), A2 (with accessory RAs <3.0 mm in diameter), and A3 (with accessory RAs ≥3.0 mm in diameter]. A1 and A2 types were eligible for RDN with the Simplicity Flex catheter. Type B included twi subtypes based on the main RA length and diameter. Patients were accordingly classified into three eligibility categories: complete (CE; both RAs were eligible), partial (PE; one eligible RA), and noneligibility (NE; no eligible RA).

RESULTS:

Bilateral A1 type was the most prevalent and was observed in 48.4 % of the patients followed by the A1/A2 type (18 %). CE, PE, and NE were observed in 69.7, 22.9, and 7.4 % of patients, respectively. The prevalence of accessory RAs was 41 %.

CONCLUSIONS:

Of RH patients, 30.3 % were not eligible for bilateral RDN with the current Simplicity Flex catheter. This classification provides the basis for standardized reporting to allow for pooling of results of larger patient cohorts in the future.

PMID:
24595661
DOI:
10.1007/s00270-014-0865-6
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center