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Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension

Catheter-based renal denervation (RDN) has been investigated for hypertension (HTN) treatment with variable success. One of the novel approaches to RDN is the delivery of micro-doses of dehydrated alcohol to the adventitial space of the renal artery to perform perivascular ablation of the sympatheti...

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Autores principales: Janas, Adam, Król, Marek, Hochuł, Mariusz, Jochymczyk, Monika, Hayward-Costa, Claudia, Parise, Helen, Haratani, Nicole, Fischell, Tim, Wojakowski, Wojciech
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356226/
https://www.ncbi.nlm.nih.gov/pubmed/32560164
http://dx.doi.org/10.3390/jcm9061881
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author Janas, Adam
Król, Marek
Hochuł, Mariusz
Jochymczyk, Monika
Hayward-Costa, Claudia
Parise, Helen
Haratani, Nicole
Fischell, Tim
Wojakowski, Wojciech
author_facet Janas, Adam
Król, Marek
Hochuł, Mariusz
Jochymczyk, Monika
Hayward-Costa, Claudia
Parise, Helen
Haratani, Nicole
Fischell, Tim
Wojakowski, Wojciech
author_sort Janas, Adam
collection PubMed
description Catheter-based renal denervation (RDN) has been investigated for hypertension (HTN) treatment with variable success. One of the novel approaches to RDN is the delivery of micro-doses of dehydrated alcohol to the adventitial space of the renal artery to perform perivascular ablation of the sympathetic nerves. We sought to assess the safety and efficiency of transcatheter alcohol-mediated perivascular renal denervation in patients with resistant hypertension. Fifty adult patients who had been referred for resistant HTN were screened. To qualify for the study, the patients had to have a mean 24 h systolic pressure ≥ 135 mmHg based upon ambulatory blood pressure monitoring (ABPM) and acceptable renal artery anatomy confirmed by the contrast computer tomography (AngioCT) and nephrologist consultation. Ten patients were eligible for chemical RND. There were no safety issues throughout the 24 months of follow-ups. The mean decrease in the office BP (OBP) was significant during 24 months of follow-up (p < 0.01). The difference in the BP in the ABPM was statistically significant in the 1st, 3rd and 12th months (p < 0.01), whereas during the 3-month follow-up, a trend was observed. The modifications of anti-hypertension drugs throughout the follow-up period were minimal. This study has shown that transcatheter alcohol-mediated renal denervation in patients with resistant hypertension is feasible and safe. Nevertheless, it is a hypothesis-generating study.
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spelling pubmed-73562262020-07-31 Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension Janas, Adam Król, Marek Hochuł, Mariusz Jochymczyk, Monika Hayward-Costa, Claudia Parise, Helen Haratani, Nicole Fischell, Tim Wojakowski, Wojciech J Clin Med Article Catheter-based renal denervation (RDN) has been investigated for hypertension (HTN) treatment with variable success. One of the novel approaches to RDN is the delivery of micro-doses of dehydrated alcohol to the adventitial space of the renal artery to perform perivascular ablation of the sympathetic nerves. We sought to assess the safety and efficiency of transcatheter alcohol-mediated perivascular renal denervation in patients with resistant hypertension. Fifty adult patients who had been referred for resistant HTN were screened. To qualify for the study, the patients had to have a mean 24 h systolic pressure ≥ 135 mmHg based upon ambulatory blood pressure monitoring (ABPM) and acceptable renal artery anatomy confirmed by the contrast computer tomography (AngioCT) and nephrologist consultation. Ten patients were eligible for chemical RND. There were no safety issues throughout the 24 months of follow-ups. The mean decrease in the office BP (OBP) was significant during 24 months of follow-up (p < 0.01). The difference in the BP in the ABPM was statistically significant in the 1st, 3rd and 12th months (p < 0.01), whereas during the 3-month follow-up, a trend was observed. The modifications of anti-hypertension drugs throughout the follow-up period were minimal. This study has shown that transcatheter alcohol-mediated renal denervation in patients with resistant hypertension is feasible and safe. Nevertheless, it is a hypothesis-generating study. MDPI 2020-06-16 /pmc/articles/PMC7356226/ /pubmed/32560164 http://dx.doi.org/10.3390/jcm9061881 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Janas, Adam
Król, Marek
Hochuł, Mariusz
Jochymczyk, Monika
Hayward-Costa, Claudia
Parise, Helen
Haratani, Nicole
Fischell, Tim
Wojakowski, Wojciech
Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension
title Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension
title_full Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension
title_fullStr Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension
title_full_unstemmed Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension
title_short Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension
title_sort evaluation of transcatheter alcohol-mediated perivascular renal denervation to treat resistant hypertension
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356226/
https://www.ncbi.nlm.nih.gov/pubmed/32560164
http://dx.doi.org/10.3390/jcm9061881
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