Feature | May 21, 2014

Renal Denervation May Reduce Hypertension in Patients With Renal Artery Stents

Journal of Endovascular Therapy Hypertension Renal Denervation Therapy

May 21, 2014 — Patients with hypertension after renal artery stenting who do not respond to drug treatment may have another option. Renal sympathetic denervation can help lower blood pressure by desensitizing nerve endings in the vascular wall. However, recent studies of this treatment concept have excluded patients with stented renal arteries.

The Journal of Endovascular Therapy presents a proof-of-concept study of 10 patients with renal artery stents who were treated with radiofrequency renal denervation. The study examined office blood pressure and ambulatory blood pressure measurements, medication, and renal assessment at baseline and at three, six and 12 months following the procedure.

In this procedure, a catheter is inserted into the arteries leading to the kidney, and radiofrequency energy is dispensed to a segment of the artery, keeping a safe distance of 5 mm from the stented segments. Once the nerve endings are desensitized, the renal sympathetic activity is reduced and decreased blood pressure can result.

Current international guidelines, however, exclude patients with an artery stent because of concern that application of radiofrequency through a metallic stent might induce restenosis or occlusion. Alternate technologies for producing denervation, such as ultrasound, brachytherapy, and local drug delivery, are also under clinical investigation.

In this study, a successful response to treatment was considered a reduction of at least 10 mm Hg in office blood pressure as well as renal artery patency. Nine of the 10 patients met this goal. The patients showed sustained decreased readings in office blood pressure from baseline to three, six and 12 months. Initial readings averaging about 190/84 mm Hg declined to 158/76 mm Hg after 12 months. No renal artery restenosis or aneurysm had occurred at one year.

While this article makes a case for the expansion of renal denervation studies to include patients with stents, an accompanying commentary points to other trials of this procedure that have not met with the same success. This issue of the journal also includes a case study outlining complications. Also noted are the recently released six-month results of the SYMPLICITY HTN-3 trial comparing renal denervation against a sham procedure. The results show no significant differences between the two approaches. The commentary urges a case-by-case consideration for renal denervation while further research is conducted.

Full text of the article, “Renal Denervation for Hypertension Refractory to Renal Artery Stenting” and commentary article, Journal of Endovascular Therapy, Vol. 21, No. 2, 2014, are now available.

For more information: www.jevtonline.org, www.isesonline.org

Related Content

Analytics 4 Life and Actelion to Develop New Diagnostics for Pulmonary Hypertension
News | Hypertension | December 14, 2018
Digital health company Analytics 4 Life and Actelion Pharmaceuticals Ltd. announced a collaborative agreement to...
Hypertensive Crisis Five Times More Likely Among Blacks, according to a late-breaking study at AHA 2018. #AHA #AHA18 #AHA2018
News | Hypertension | November 13, 2018
Black adults experience dangerous spikes in high blood pressure, called a hypertensive crisis, at a rate that is five...
Home Monitoring Confirms Clinic Diagnosis of High Blood Pressure
News | Hypertension | October 29, 2018
Blood pressure readings of 130/80 millimeters of mercury (mmHg) or higher taken at home can be used to diagnose...
 Pulmonary artery denervation for CpcPH from the PADN-5 trial. #TCT2017

A series of procedural images of a pulmonary artery denervation for CpcPH from the PADN-5 trial.

News | Hypertension | October 04, 2018
October 4, 2018 — Pulmonary artery denervation (PADN) is associated with significant improvements in hemodynamic and
BackBeat Cardiac Neuromodulation Therapy Reduces Blood Pressure at Two Years
News | Hypertension | October 02, 2018
Two-year results of the Moderato I Study demonstrated immediate, substantial and sustained reduction in blood pressure...
Most Black Adults Have High Blood Pressure Before Age 55
News | Hypertension | July 30, 2018
July 30, 2018 — Approximately 75 percent of black and men women are...
American Heart Association Announces New Hypertension Center Certification
News | Hypertension | July 05, 2018
Physician practices now have access to new resources to improve their standard of quality care for hypertension...
YMCA and American Heart Association Partner to Improve Blood Pressure Control
News | Hypertension | April 05, 2018
YMCA of the USA (Y-USA) and the American Heart Association (AHA) are combining efforts to help more people better...
Higi Implementing New ACC/AHA Blood Pressure Guidelines at 11,000 North American Stations
News | Hypertension | March 28, 2018
Population health enablement company Higi announced their commitment to implement the 2017 American College of...
Overlay Init