Anatomical eligibility of the renal vasculature for catheter-based renal denervation in hypertensive patients.

Rimoldi, Stefano; Scheidegger, Niklaus; Scherrer, Urs; Farese, Stefan; Rexhaj, Emrush; Moschovitis, Aris; Windecker, Stephan; Meier, Bernhard; Allemann, Yves (2014). Anatomical eligibility of the renal vasculature for catheter-based renal denervation in hypertensive patients. JACC. Cardiovascular Interventions, 7(2), pp. 187-192. Elsevier 10.1016/j.jcin.2013.10.013

[img] Text
1-s2.0-S193687981301683X-main.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (415kB) | Request a copy

OBJECTIVES This study sought to determine the vascular anatomical eligibility for catheter-based renal artery denervation (RDN) in hypertensive patients. BACKGROUND Arterial hypertension is the leading cardiovascular risk factor for stroke and mortality globally. Despite substantial advances in drug-based treatment, many patients do not achieve target blood pressure levels. To improve the number of controlled patients, novel procedure- and device-based strategies have been developed. RDN is among the most promising novel techniques. However, there are few data on the vascular anatomical eligibility. METHODS We retrospectively analyzed 941 consecutive hypertensive patients undergoing coronary angiography and selective renal artery angiography between January 1, 2010, and May 31, 2012. Additional renal arteries were divided into 2 groups: hilar (accessory) and polar (aberrant) arteries. Anatomical eligibility for RDN was defined according to the current guidelines: absence of renal artery stenosis, renal artery diameter ≥4 mm, renal artery length ≥20 mm, and only 1 principal renal artery. RESULTS A total of 934 hypertensive patients were evaluable. The prevalence of renal artery stenosis was 10% (n = 90). Of the remaining 844 patients without renal artery stenosis, 727 (86%) had nonresistant hypertension and 117 (14%) had resistant hypertension; 62 (53%) of the resistant hypertensive and 381 (52%) of the nonresistant hypertensive patients were anatomically eligible for sympathetic RDN. CONCLUSIONS The vascular anatomical eligibility criteria of the current guidelines are a major limiting factor for the utilization of RDN as a therapeutic option. Development of new devices and/or techniques may significantly increase the number of candidates for these promising therapeutic options.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Rimoldi, Stefano; Scherrer, Urs; Rexhaj, Emrush; Moschovitis, Aris; Windecker, Stephan; Meier, Bernhard and Allemann, Yves

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1876-7605

Publisher:

Elsevier

Language:

English

Submitter:

Stefano Rimoldi

Date Deposited:

18 Jul 2014 11:46

Last Modified:

02 Nov 2015 10:09

Publisher DOI:

10.1016/j.jcin.2013.10.013

PubMed ID:

24440022

Uncontrolled Keywords:

anatomical eligibility, arterial hypertension, renal vascular anatomy, sympathetic renal denervation

BORIS DOI:

10.7892/boris.43124

URI:

https://boris.unibe.ch/id/eprint/43124

Actions (login required)

Edit item Edit item
Provide Feedback