Safety and Feasibility of Renal Sympathetic Denervation in Patients With Insufficient Renal Artery Length

Vasc Endovascular Surg. 2016 Jan;50(1):63-7. doi: 10.1177/1538574416629564.

Abstract

Insufficient renal artery length for renal sympathetic denervation (RDN) is defined as having a main renal artery shorter than 20 mm in length. Such an anatomy is considered a contraindication for most of the currently available endovascular RDN devices. The concern stems from the need to distribute the ablation points to effect circumferential ablation causing sympathetic denervation, without the risk of injuring the renal artery. We postulate that if the requisite ablation points could be distributed between large caliber renal branches and the short main renal artery, RDN is likely feasible and safe. We demonstrate this with 2 cases using 2 different RDN devices and detail the technical feasibility.

Keywords: denervation; renal; sympathetic.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Aortography
  • Blood Pressure* / drug effects
  • Drug Resistance
  • Humans
  • Hypertension / diagnosis
  • Hypertension / physiopathology
  • Hypertension / surgery*
  • Kidney / blood supply*
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Patient Selection
  • Predictive Value of Tests
  • Renal Artery / abnormalities
  • Renal Artery / diagnostic imaging
  • Renal Artery / innervation*
  • Sympathectomy / methods*
  • Treatment Outcome
  • Vascular Malformations / complications*
  • Vascular Malformations / diagnostic imaging

Substances

  • Antihypertensive Agents