This treatment is performed in patients suffering from resistant hypertension. This diagnosis is when someone has an excessive pressure in the bloodstream of the arteries but cannot lower it, even if they are taking more than three drugs a day and has made changes in their lifestyle habits.
Renal denervation is performed by inserting a catheter with four electrodes into the renal arteries via the femoral approach. Once the device is in place, the catheter emits a heat of between 40 and 50 degrees to cancel out small nerves that are in the renal artery. In this way, the kidney creates a smaller amount of the hormones that increase the tension. The intervention is performed on both kidneys.
The procedure is carried out under a local anaesthetic and takes around an hour. You may need to stay in hospital overnight following the procedure but should be able to return to your daily activities afterwards.
The main risk of renal denervation is dissection of the renal artery, but this can be treated with a stent. Other risks include bruising and bleeding. Prevalence of resistant hypertension in the United States, — Daugherty, S. Incidence and prognosis of resistant hypertension in hypertensive patients. Krum, H. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study.
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Pappaccogli, M. Henegar, J. Fengler, K. Circulation Sanders, M. Renal safety of catheter-based renal denervation: systematic review and meta-analysis. Moher, D. Lancet London, England , — Jadad, A. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Controlled clinical trials 17 , 1—12 Duval, S. Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 56 , — Sterne, J.
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Pradyumna Agasthi designed the study, extracted the data, drafted the initial manuscript and critically reviewed the manuscript. Justin Shipman extracted the data, drafted the initial manuscript and critically reviewed the manuscript.
Reza Arsanjani designed the study, extracted the data and critically reviewed the manuscript. Girardo analyzed the data, prepared the figures and critically reviewed the manuscript. Charan Yerasi analyzed the data, prepared the figures and critically reviewed the manuscript. Floyd David Fortuin critically reviewed the manuscript.
Farouk Mookadam designed the study and critically reviewed the manuscript. All authors have read and approved the final manuscript. Correspondence to Pradyumna Agasthi. The sympathetic nervous system plays a significant pathophysiological role in hypertension. Surgical sympathectomy for blood pressure reduction is an old but extremely efficacious therapeutic concept, since abandoned, with the dawn of safer contemporary pharmacology era.
Recently, clinical studies have revealed promising results for safe and sustained blood pressure reduction with percutaneous renal sympathetic denervation.
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