What the interventionalist should know about renal denervation in hypertensive patients: a position paper by the ESH WG on the interventional treatment of hypertension

Abstract

Percutaneous catheter-based transluminal renal denervation (RDN) has emerged as a new approach to achieve sustained blood pressure reduction in patients with drug-resistant hypertension. Experts from ESH and ESC in their recently released position papers and consensus document have summarised the current evidence, unmet needs and practical recommendations for the application of this therapeutic strategy in clinical practice. Experts of the ESH Working Group for the interventional treatment of hypertension prepared this position paper in order to provide interventionalists with guidance through the procedure of RDN. Given that there is no established intraprocedural control of ablation success, interventionalists have to be familiar with the aspects related to the anatomy and imaging of the renal arteries, the distribution of renal sympathetic fibres, the special equipment necessary for RDN and the procedural details in order to maximise the success and minimise potential complications.

Reduced Effect of Percutaneous Renal Denervation on Blood Pressure in Patients With Isolated Systolic Hypertension

“…Only patients with stable antihypertensive drug regimen were included in the study and patients with secondary, treatable causes of hypertension were excluded. 16 Stable antihypertensive drug regime was defined as no change in antihypertensive medication for ≥4 weeks prior RDN. Patients and physicians were instructed not to change antihypertensive medication during the study period except when medically required.…”

Resistant Arterial Hypertension: Is the Consensus Between Conservative and Interventional Therapy Possible?

“…В июле 2013 г. были опубликованы систематический обзор и мета-ана-лиз, включавшие 2 рандомизированных и 10 обсер-вационных исследований, демонстрирующих высокую эффективность и безопасность РДН при РГ [32]. В том же 2013 г. метод нашел отражение в Консенсусе экс-пертов ESC по катетерной ренальной денервации и Меж-дународном Консенсусе экспертов по чрескожной транслюминальной ренальной денервации [33][34][35].…”

Renal Denervation and Symplicity HTN-3

“…1 RDN has been shown to be safe in almost all previously published studies, [2][3][4][5][6][7][8][9] and preservation of renal function has been established even in patients with baseline renal insufficiency. 10,11 Vascular complications are rather rare, whereas renal artery stenosis is an infrequent event.…”