Does the Presence of Accessory Renal聽Arteries Affect the Efficacy of Renal Denervation?

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• 作者：Dani Id ; Benjamin Kaltenbach ; Stefan C. Bertog ; Marius Hornung ; Ilona Hofmann ; Laura Vaskelyte ; Horst Sievert
• 关键词：accessory ; arterial hypertension ; radiofrequency ablation ; renal artery ; renal denervation
• 刊名：JACC: Cardiovascular Interventions
• 出版年：October, 2013
• 年：2013
• 卷：6
• 期：10
• 页码：1085-1091
• 全文大小：493 K

文摘

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Objectives

This study sought to assess the efficacy of catheter-based renal sympathetic denervation in patients with accessory renal arteries and to compare the blood pressure (BP)-lowering effect with that observed in patients with bilateral single renal arteries after renal denervation.

Background

Catheter-based renal sympathetic denervation causes significant BP reductions in patients with resistant hypertension.

Methods

Seventy-four patients were included in this study. Patients were assigned to 2 main groups: a bilateral single renal arteries group I (n聽= 54) and an accessory renal arteries group II (n聽= 20). Group II consisted of 9 patients whose accessory renal arteries were all denervated (group IIa), and 11 patients whose accessory renal arteries were not, or only incompletely, denervated (group IIb). The primary endpoint was the change in office systolic BP after 6 months.

Results

The procedure was successful in all patients. Group I: mean BP at baseline was 166.2/89.4 卤聽20.5/14.6 mm Hg and decreased by聽鈭?6.6 (p < 0.001)/鈭?.7 (p聽= 0.016) 卤 16.4/11 mm Hg at 6-month follow-up. Group II: mean BP at baseline was 164.2/89.1 卤 19.9/15.4 mm Hg and decreased by聽鈭?.2 (p聽= 0.19)/鈭?.2 (p聽= 0.5) 卤 19.7/11.3 mm Hg at 6-month follow-up. Patients in group IIa had聽an office BP reduction of聽鈭?.8 (p聽= 0.2)/1.1 卤 17.9/10.8 mm Hg and patients in group IIb of聽鈭?.1聽(p聽=聽0.55)/鈭?.3 卤 20.8/11.6 mm Hg. Similarly, significant improvements in 24-h mean systolic BP were seen in group I (鈭?.3 卤 17.4 mm Hg, p < 0.01), whereas none were seen in group II (鈭?.7聽卤聽8.3 mm Hg, p聽= 0.38).

Conclusions

BP reduction achieved after renal denervation in patients with accessory renal arteries is聽less pronounced than in patients with bilateral single renal arteries.