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Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension.
J Clin Med. 2020 Jun 16; 9(6)JC

Abstract

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.

Authors+Show Affiliations

Center of Cardiovascular Research and Development, American Heart of Poland, 40-534 Ustroń, Poland. Faculty of Medicine and Health Science, Andrzej Frycz-Modrzewski Krakow University, 30-705 Kraków, Poland.Center of Cardiovascular Research and Development, American Heart of Poland, 40-534 Ustroń, Poland.Center of Cardiovascular Research and Development, American Heart of Poland, 40-534 Ustroń, Poland.Center of Cardiovascular Research and Development, American Heart of Poland, 40-534 Ustroń, Poland.Ablative Solutions Inc., San Jose, CA 95119, USA.Ablative Solutions Inc., San Jose, CA 95119, USA.Ablative Solutions Inc., San Jose, CA 95119, USA.Ablative Solutions Inc., San Jose, CA 95119, USA.Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-635 Katowice, Poland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32560164

Citation

Janas, Adam, et al. "Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension." Journal of Clinical Medicine, vol. 9, no. 6, 2020.
Janas A, Król M, Hochuł M, et al. Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension. J Clin Med. 2020;9(6).
Janas, A., Król, M., Hochuł, M., Jochymczyk, M., Hayward-Costa, C., Parise, H., Haratani, N., Fischell, T., & Wojakowski, W. (2020). Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension. Journal of Clinical Medicine, 9(6). https://doi.org/10.3390/jcm9061881
Janas A, et al. Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension. J Clin Med. 2020 Jun 16;9(6) PubMed PMID: 32560164.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluation of Transcatheter Alcohol-Mediated Perivascular Renal Denervation to Treat Resistant Hypertension. AU - Janas,Adam, AU - Król,Marek, AU - Hochuł,Mariusz, AU - Jochymczyk,Monika, AU - Hayward-Costa,Claudia, AU - Parise,Helen, AU - Haratani,Nicole, AU - Fischell,Tim, AU - Wojakowski,Wojciech, Y1 - 2020/06/16/ PY - 2020/05/07/received PY - 2020/06/06/revised PY - 2020/06/09/accepted PY - 2020/6/21/entrez PY - 2020/6/21/pubmed PY - 2020/6/21/medline KW - local drug delivery KW - renal denervation KW - resistant hypertension JF - Journal of clinical medicine JO - J Clin Med VL - 9 IS - 6 N2 - 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. SN - 2077-0383 UR - https://www.unboundmedicine.com/medline/citation/32560164/Evaluation_of_Transcatheter_Alcohol-Mediated_Perivascular_Renal_Denervation_to_Treat_Resistant_Hypertension L2 - https://www.mdpi.com/resolver?pii=jcm9061881 DB - PRIME DP - Unbound Medicine ER -
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