DOI: https://doi.org/10.22141/2224-1485.3.35.2014.82720

Own Experience of Patient Selection for Renal Denervation

G.S. Dobrokhod

Abstract


Renal denervation (RDN) — a new drug-free approach to treating resistant arterial hypertension (AH). Today, the efficacy and safety of RDN are continue to be studied. Success of the procedure depends on the proper selection of patients. ESH/ESC experts recommend to recourse to RDN only in verified resistant essential AH. In this study, we analyzed data of 674 patients with resistant AH to determine which patients are subject to RDN and what characteristics of patients limit widespread introduction of this method of treatment. Most our patients had pseudoresistant AH — approximately 58 %, 9 % had symptomatic AH, most patients had unacceptable anatomy of the renal arteries, some patients refused the procedure due to personal convictions. As a result, only 8 patients underwent RDN, that is 1.2 % of all persons included in the previous screening. Our results are consistent with international experience of patient selection for RDN.

References


Болгарский И.С. О частоте множественных почечных артерий и их клиническое значение // Урология и нефрология. — 1965. — № 4. — С. 16-24.

Кафаров Э. С. Вариантная анатомия почечной артерии и ее ветвей: Автореф. дис… канд. мед. наук. — Волгоград, 2004.

Коваленко В.Н., Соколов Ю.Н., Сиренко Ю.Н., Соколов М.Ю., Рековец О.Л., Доброход А.С. Применение радиочастотной абляции для почечной денервации у пациентов с резистентной гипертензией в Украине с использованием международных рекомендаций и сертифицированного оборудования // Артериальная гипертензия. — 2012. — № 4(24). — С. 31-41.

Крылов А.А. Некоторые особености строения и топографии добавочных артерий почек и их практическое значение // Патогенез, диагностика и лечение ряда заболеваний сердечно-сосудистой системы. — Ленинград, 1982. — С. 22-25.

Плащинская Л.И., Гончарик Д.Б., Часнойт А.Р., Голенища В.Ф., Савченко А.А., Мрочек А.Г. Опыт катетерной абляции симпатических нервов почечных артерий у пациентов с резистентной артериальной гипертензией // Артериальная гипертензия и профилактика сердечно-сосудистых заболеваний: Мат-лы VII Междунар. конф., Витебск, 23–24 мая 2013 г. — Витебск, 2013. — С. 321-322.

Уніфікований клінічний протокол первинної, екстреної та вторинної (спеціалізованої) медичної допомоги «Артеріальна гіпертензія». Наказ Міністерства охорони здоров’я України від 24 травня 2012 року № 384.

Addo J., Smeeth L. &Lean D.A. Hypertensionin Sub-Saharan Africа // A Systematic Review Hypertension. — 2007. — 50. — 1012.

Azizi M., Steichen O., Frank M., Bobrie G., Plouin P.F., Sapoval M. Catheter-based radiofrequency renal-nervea blationin patients with resistanthypertension // Eur. J. Vasc. Endovasc. Surg. — 2012. — 43. — 293-299.

Jung O., Gechter J.L., Wunder C., Paulke A., Bartel C., Geiger H., Toennes S.W. Resistant hypertension? Assessment of adherence by toxicological urineanalysis // J. Hypertens. — 2013 Apr. — 31(4). — 766-74. doi: 10.1097/HJH.

Linz D., Mahfoud F., Linz B., Hohl M., Schirmer S.H., Wirth K.J., Böhm M. Effect of Obstructive Respiratory Events on Blood Pressure and Renal Perfusionin a Pig Model for Sleep Apnea // Am. J. Hypertens. — 2014 Mar 12. [Epubaheadofprint].

Mancia G., Fagard R., Narkiewicz K., Redon J., Zanchetti A., Bohm M., et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) // Eur. Heart J. — 2013. — 34. — 2159-2219.

Marrs J.C. Spironolactone management of resistant hypertension // Ann. Pharmacother. — 2010 Nov. — 44(11). — 1762-9. doi: 10.1345/aph.1P338. Epub 2010 Oct 26.

Medtronic Announces U.S. Renal Denervation Pivotal Trial Failsto Meet Primary Efficacy Endpoint While Meeting Primary Safety Endpoint [pressrelease] January 9, 2014. http://newsroom.medtronic.com/phoenix.zhtml?c=251324&p=irol-newsArticle&ID=1889335

National Clinical Guideline Centre. Hypertension: the clinical management of primary hypertension in adults. Update of Clinical Guidelines 18 and 34. August 2011. http://www.ncbi.nlm.nih.gov/books/NBK83274/pdf/TOC.pdf Accessed December 31, 2012

Plehn Alexander, Dietz Sebastian, Heinroth Konstantin, Lemm Henning, Leuthold Maria, Markau Silke et al. TCT-11 Renal Sympathetic Denervation – Inducing An Instantaneous And Persisting 24h Ambulatory Blood Pressure Drop In Patients With Resistant Hypertension — Results From The Halle-RDN-Registry // J. Am. Coll. Cardiol. — 2012. — 60. doi:10.1016/j.jacc.2012.08.016.

Pantelis A. Sarafidis, George L. Bakris et al. Resistant Hypertension. An Overview of Evaluation and Treatment // J. Am. Coll. Cardiol. — 2008. — 52(22). — 1749-1757.

Savard S., Frank M., Bobrie G., Plouin P.F., Sapoval M., Azizi M. Eligibility for renal denervation in patients with resistant hypertension: when enthusiasm meets reality in real-life patients // J. Am. Coll. Cardiol. — 2012. — 60. — 2422-2424.

ESH Position Paper: Renal denervation — an interventional therapy of resistant hypertension // Journal of Hypertension. — May 2012. — Volume 30, Issue 5. — Р. 837-841.

Simplicity HTN-1 Investigators 2011. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months // Hypertension. — 2011. — 57. — 911-917.

Simplicity HTN-2 Investigators, Esler M.D., Krum H., Sobotka P.A., Schlaich M.P., Schmieder R.E., Bohm M. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial // Lancet. — 2010. — 376. — 1903-1909.

Tobias Graf, Christian Fatum, Anne U. Hansen, Kai Mortensen, Joachim Weil. TCT-500 Effect of Renal Denervation (RDN) in Real World Patients with rHTN Compared to Simplicity HTN-2 Trial. First Results of the Luebeck RDN Registry // J. Am. Coll. Cardiol. — 2013. — 62.

Trewet C.L., Ernst M.E. Resistant hypertension: identifying causes and optimizing treatment regimens // South. Med. J. — 2008. — 101. — 166-173.

Viera A., Neutze D.M. // Am. Fam. Physician. — 2010 Dec 15. — 82(12). — 1471-1478.

Vrijens B., Vincze G., Kristanto P., Urquhart J., Burnier M. Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing histories // BMJ. — 2008. — 336. — 1114-1117.

Yaduvanshi Amitabh, Nair Mohan. CRT-128 Renal Artery Denervationin Chronic Kidney Disease Patients // J. Am. Coll. Cardiol. Int. — 2013. doi:10.1016/j.jcin.2013.01.052.

Yang Jeong Hoon, Choi Seung-Hyuk, Gwon Hyeon-Cheol. Percutaneous Renal Sympathetic Denervation for the Treatment of Resistant Hypertension with Heart Failure: First Experience in Korea // J. Korean Med. Sci. — Jun 2013. — 28(6). — 951-954.




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