Percutaneous renal denervation for the treatment of resistant essential hypertension; the first dutch experience

Abstract

Background In a subpopulation of patients with essential hypertension, therapeutic targets are not met, despite the use of multiple types of medication. In this paper we describe our first experience with a novel percutaneous treatment modality using renal artery radiofrequency (RF) ablation. Methods Patients who were resistant to at least three types of antihypertensive medical therapy (office systolic blood pressure≥160 mmHg; n=9) or who did not tolerate medication (n=2) were selected. Between July and November 2010, a total of 11 patients received percutaneous RF treatment. Patients were followed up for 1 month after treatment. Urine and blood samples were taken to evaluate the effects on renal function and neurohumeral factors. Results No periprocedural complications or adverse events during follow-up were noted. A reduction of mean office blood pressure was seen from 203/109±32/19 mmHg at baseline to 178/97±28/21 mmHg at 1 month follow-up (mean difference 25±12 mmHg, p<0.01). Also, we noted a significant decrease in aldosterone level (391±210 pmol/L versus 250±142 pmol/L; p=0.03), while there was no decrease in plasma renin activity (190±134 fmol/L/s versus 195±163 fmol/L/s; p=0.43). No change in renal function was noted. Conclusion Catheter-based renal denervation seems an attractive novel minimally invasive treatment option in patients with resistant hypertension, with a low risk of serious adverse events. © The Author(s) 2011. This article is published with open access at Springerlink.com.