Radiofrequency renal denervation with different device for treatment in patient with uncontrolled hypertension

Abstract

Objective. To study the efficacy and safety of radiofrequency renal denervation with mono-electrode and multi-electrode devices in patients with uncontrolled arterial hypertension during follow-up period. Materials and methods. The study included 42 patients with uncontrolled arterial hypertension (mean age 51±12 years), while receiving multicomponent antihypertensive therapy, including diuretic. All patients underwent radiofrequency denervation of the renal arteries with a mono-electrode (n=27; group A) and multi-electrode devices (n=15; group B). The safety of the procedure was assessed using creatinine and glomerular filtration rate (MDRD equation), as well as according to ultrasound of the kidneys and renal arteries. The effectiveness of the procedure was study according to office blood pressure (BP) and ambulatory BP monitoring (ABPM). Results. In the general group, according to office BP after 6 months, there decreased in systolic (SBP)/diastolic BP (DBP) by 28/13 mm Hg (p=0.000001). According to ABPM, there was a decrease in the average daily SBP by 9 mm Hg (p=0.007) and DBP by 6 mm Hg (p=0.03). No significant changes in creatinine and glomerular filtration rate were detected in the general group. According to ABPM, after 6 months in group B, there was a decrease in the average daily SBP/DBP by 13 and 6 mm Hg (p=0.1). In group A, according to the ABPM, after 6 months, there was a decrease in the average daily SBP and DBP by 7 mm Hg (p=0.001) and 4 mm Hg (p=0.03). After 1 year, according to the office BP, there was a decrease in SBP/DBP by 14/11 mm Hg (p=0.002), and after 3 years at 15/17 mm Hg (p=0.3). Conclusion. The results confirm the safety and efficacy of radiofrequency renal denervation. Renal denervation in combination with drug therapy leads to decreasing of BP after 6 months and in the long-term

Uncontrolled arterial hypertension: main causes, features of pathogenesis and approaches to treatment

“…А.Л. Мясникова денервация почечных артерий проводится с ноября 2011 г. по настоящее время [65][66][67].…”

Refractory and resistant hypertension in patients with type 2 diabetes mellitus: differences in metabolic profile and endothelial function

“…Мы не имели возможности установить, какова роль нарушений эндотелиальной дисфункции при рефрактерной аГ, являются ли они ее этиологическими факторами или служат маркерами симпатической гиперактивации и следствием более тяжелого течения аГ, однако эти вопросы могут стать предметом будущих исследований. кроме того, поскольку рефрактерная аГ предположительно имеет нейрогенную этиологию, а проведение симпатической ренальной денервации рассматривается в качестве эффективного способа снижения симпатической активности и лечения раГ [34][35][36][37][38][39][40], дальнейшие исследования помогут установить, имеют ли больные рефрактерной аГ преимущества от ренальной денервации по сравнению с пациентами с неконтролируемой раГ.…”

Radiofrequency renal denervation with mono-electrode and multi-electrode device for treatment in patient with uncontrolled hypertension: results of a 6-month follow-up

“…А.Л. Мясникова впервые была проведена ренальная денервация с применением моноэлектродного устройства Symplicity Flex [12], а в октябре 2018 г. -с мультиэлектродным катетером II поколения Symplicity Spyral с использованием комбинированной техники ренальной денервации [13].…”