Noninvasive Renal Denervation for Resistant Hypertension Using High-Intensity Focused Ultrasound

Shu, Rong; Zhu, Hui; Liu, Dichuan; Qian, Jun; Zhou, Kun; Zhu, Qingsan; Jiang, Yonghong; Yang, Gang; Deng, Changming; Zhang, Dengqing; Zhou, Qi; Lv, Han; He, Tong‐Chuan; Wang, Zhibiao; Jing, Huang

doi:10.1161/hypertensionaha.115.05754

Cited by 21 publications

(14 citation statements)

References 12 publications

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“…This study aimed to assess the potential benefit of IL-17A deficiency or therapeutic blockade in a translational mouse model of ischaemia-induced AKI which proceeds to progressive renal fibrosis. [17,18] Strikingly, neither genetic deficiency of IL-17A nor pharmacological IL-17A neutralization affected the course of acute inflammation, tubular damage or renal fibrosis. This was unexpected because IL-17 a potent pro-inflammatory cytokine that is secreted primarily by activated T cells has been implicated in several inflammatory diseases.…”

Section: Discussionmentioning

confidence: 99%

IL-17A blockade or deficiency does not affect progressive renal fibrosis following renal ischaemia reperfusion injury in mice

Thorenz

Völker

Bräsen

et al. 2017

Journal of Pharmacy and Pharmacology

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Section: Discussionmentioning

confidence: 99%

IL-17A blockade or deficiency does not affect progressive renal fibrosis following renal ischaemia reperfusion injury in mice

Thorenz

Völker

Bräsen

et al. 2017

Journal of Pharmacy and Pharmacology

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“…9 Renal denervation adalah prosedur ablasi nervus renalis dengan menggunakan radiofrekuensi untuk mengurangi aktivitas simpatik saraf renalis sehingga dapat menurunkan tekanan darah. 18 Percobaan preklinis pada hewan coba dan beberapa studi klinis pada manusia menunjukan hasil yang baik pada penurunan tekanan darah. 18 Ada beberapa teknik renal denervation, antara lain reseksi saraf splanknik ginjal, kateter Radiofrequency Ablation (RFA), dan yang terbaru, High-Intensity Focused Ultrasound (HIFU).…”

Section: Renal Denervation (Rdn)unclassified

“…18 Percobaan preklinis pada hewan coba dan beberapa studi klinis pada manusia menunjukan hasil yang baik pada penurunan tekanan darah. 18 Ada beberapa teknik renal denervation, antara lain reseksi saraf splanknik ginjal, kateter Radiofrequency Ablation (RFA), dan yang terbaru, High-Intensity Focused Ultrasound (HIFU). 18 Teknik pertama yang diperkenalkan dalam renal denervation adalah reseksi.…”

Section: Renal Denervation (Rdn)unclassified

“…18 Ada beberapa teknik renal denervation, antara lain reseksi saraf splanknik ginjal, kateter Radiofrequency Ablation (RFA), dan yang terbaru, High-Intensity Focused Ultrasound (HIFU). 18 Teknik pertama yang diperkenalkan dalam renal denervation adalah reseksi. Hasil evaluasi menunjukkan adanya penurunan tekanan darah dan hilangnya gejala pada pasien yang sebelumnya mengalami hipertensi maligna.…”

Section: Renal Denervation (Rdn)unclassified

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High Intensity Focused Ultrasound: Terapi Non-Invasif Efektif untuk Hipertensi Resisten

Arisandi¹

2020

J. Kdokt Meditek

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Hipertensi resisten adalah tekanan darah yang tetap di atas target walaupun sudah menggunakan minimal tiga obat antihipertensi pada dosis maksimal yang dapat ditoleransi (salah satunya diuretik) atau tekanan darah yang membutuhkan minimal empat obat untuk mencapai target tekanan darah. Salah satu pendekatan tatalaksana hipertensi resisten adalah dengan menggunakan renal denervation. Berbagai metode renal denervation berkembang, mulai dari reseksi, kateter Radiofrequency Ablation (RFA), hingga High-Intensity Focused Ultrasound (HIFU). HIFU merupakan merupakan metode terbaru dan memiliki efektivitas yang cukup menjanjikan. Hasil uji pada hewan coba dan uji klinik pada manusia menunjukkan hasil yang baik. Selain itu, HIFU merupakan metode non-invasif sehingga dapat meminimalisir efek samping prosedur invasif atau bedah. Satu-satunya efek samping yang dilaporkan adalah nyeri punggung namun dapat diatasi menggunakan obat penghilang nyeri.

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“…A novel multi electrode catheter was recently tested in a clinical trial (Medtronic Symplicity Multi electrode radio-frequency RDN system): Including 50 patients with RH, the investigators report a significant reduction in blood pressure after 12 months with a low complication rate [60]. Another developing technique is the use of high intensity focused ultrasound instead of radiofrequency ablation for use in RDN [61]. It has also to be mentioned that a recent meta-analysis comparing RDN and medical therapy revealed a strong heterogeneity among study populations [62].…”

Section: Perspectives Current Trials and Registries ▼mentioning

confidence: 99%

Recent Developments and Controversies in the Treatment of Resistant Hypertension

Kühl

Frey

Frank

2016

Exp Clin Endocrinol Diabetes

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Resistant hypertension is defined as elevated blood pressure despite the appropriate use of 3 or more antihypertensive drugs, including a diuretic, and constitutes a frequent and important clinical problem with significant disease morbidity and mortality. Several sources of evidence point to the sympathetic nervous system as a major protagonist in this disease entity. The catheter-based, radiofrequency ablation of renal sympathetic nerves (renal denervation) to treat resistant hypertension has sparked great enthusiasm. However, failure of this interventional approach in the randomized, sham-controlled Symplicity HTN-3 trial to reach its efficacy endpoint of attaining a significant blood pressure reduction has called this intervention into substantial question and fueled an ongoing scientific debate. Electrical stimulation of the carotid baroreceptors (baroreflex activation therapy) represents another technique to modulate sympathetic activity currently being studied in several clinical trials. This review summarizes and comments the current literature focusing on the invasive treatment of resistant hypertension.

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Noninvasive Renal Denervation for Resistant Hypertension Using High-Intensity Focused Ultrasound

Cited by 21 publications

References 12 publications

IL-17A blockade or deficiency does not affect progressive renal fibrosis following renal ischaemia reperfusion injury in mice

IL-17A blockade or deficiency does not affect progressive renal fibrosis following renal ischaemia reperfusion injury in mice

High Intensity Focused Ultrasound: Terapi Non-Invasif Efektif untuk Hipertensi Resisten

Recent Developments and Controversies in the Treatment of Resistant Hypertension

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