Redo renal denervation using a multi-electrode radiofrequency system in patients with persistent therapy-resistant hypertension

Abstract

Objectives Renal sympathetic denervation has been studied as a potential therapeutic option for patients with therapyresistant hypertension; however, a significant proportion of patients do not show a significant reduction in blood pressure and are classified as non-responders. The objective of the present study was to assess whether a redo renal denervation procedure increases response rates. Methods We present a case series of three consecutive renal denervation non-responders treated with the multi-electrode radiofrequency St. Jude EnligHTN catheter after an average of 22 months. Patients were followed for 6 months. Results Mean age was 66 years and two patients were male. Patients were previously treated using either ReCor’s Paradise system, the Vessix V2 system or the Covidien OneShot system. Mean office blood pressure one year after the initial procedure was 187/102mmHg with a mean 24 h ambulatory blood pressure of 166/102mmHg. All patients underwent a successful redo procedure using the EnligHTN system because of persistent therapy-resistant hypertension. At 6 months a significant drop in both office and ambulatory blood pressure of -27/-6mmHg and -15/-13mmHg, respectively, was observed. No significant renal artery stenosis was observed at 6 months. Conclusions In patients with therapy-resistant hypertension who do not respond to an initial renal denervation procedure, a redo procedure using the St. Jude EnligHTN system may help to significantly improve blood pressure control.