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Renal Sympathetic Denervation

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Renal Sympathetic Denervation, Percutaneous Renal Sympathetic Ablation

  • Indications
  1. Resistant Hypertension
  • Technique
  1. Percutaneous introduction of catheter that is introduced into each renal artery
  2. Catheter is applied to each of several areas along the renal artery course
    1. Deliver radiofrequency current to ablate Sympathetic Nerves that course along the surface of the renal arteries
  • Efficacy
  1. Systolic Blood Pressure drops by 20-30 mmHg at one year
  • Adverse Effects
  1. Renal artery dissection
    1. In initial studies, occurred in 2 of 500 patients
    2. Treated effectively with emergent stenting
  2. Renal Artery Stenosis
    1. Theororetical risk
  • Precautions
  1. Newly available procedure as of 2012 without longterm safety and efficacy data beyond one year of follow-up
  • References
  1. Gulati (2012) Mayo POIM Conference, Rochester
  2. Schlaich (2009) NEJM 36(9): 932 [PubMed]