Relevance of Targeting the Distal Renal Artery and Branches with Radiofrequency Renal Denervation Approaches-A Secondary Analysis from a Hypertensive CKD Patient Cohort.

Márcio Galindo Kiuchi; Markus P Schlaich; Shaojie Chen; Humberto Villacorta; Jan K Ho; Revathy Carnagarin; Vance B Matthews; Jocemir Ronaldo Lugon
Abstract
We searched for an association between changes in blood pressure (BP) at 12 and 24 months after renal denervation (RDN) and the different patterns of ablation spots placement along the renal artery vasculature. We performed a post-hoc analysis of a 24-month follow-up evaluation of 30 patients who underwent RDN between 2011 and 2012 using our previous database. Patients who had (i) resistant hypertension, as meticulously described previously, and (ii) Chronic kidney disease (CKD) stages 2, 3 and 4. Correlations were assessed using the Pearson or Spearman correlation tests as appropriate. The mean change in systolic ambulatory BP monitoring (ABPM) compared to baseline was -19.4 ± 12.7 mmHg at the 12th (p < 0.0001) and -21.3 ± 14.1 mmHg at the 24th month (p < 0.0001). There was no correlation between the ABPM Systolic Blood Pressure (SBP)-lowering effect and the total number of ablated spots in renal arteries (17.7 ± 6.0) either at 12 (r = -0.3, p = 0.1542) or at 24 months (r = -0.2, p = 0.4009). However, correlations between systolic BP-lowering effect and the number of ablation spots performed in the distal segment and branches were significant at the 12 (r = -0.7, p < 0.0001) and 24 months (r = -0.8, p < 0.0001) follow-up. Our findings indicate a substantial correlation between the numbers of ablated sites in the distal segment and branches of renal arteries and the systolic BP-lowering effect in the long-term.
Journal JOURNAL OF CLINICAL MEDICINE
ISSN 2077-0383
Published 27 Apr 2019
Volume 8
Issue 5
Pages
DOI 10.3390/jcm8050581
Type Journal Article
Sponsorship