COMPARISON OF FIRST RESULTS OF RADIOFREQUENCY RENAL DENERVATIONS WITH FIRST AND SECOND GENERATION TECHNIQUES

Abstract

Objective: A form of renal denervation, when using radiofrequency technique, thermal energy destroys the nerve-fibres around the renal artery. The Symplicity FlexTM was the first such catheter, an improved new generation version of it is the Symplicity SpyralTM catheter. In the Albert Szent-Györgyi Health Center of the University of Szeged, renal denervations were performed with both devices in hypertensive patients whose blood pressure could not be reduced to the goal range with multiple antihypertensive combinations. Design and method: With the first generation catheter, only the main branch was ablated at 4-5 points per side, and with the Symplicity SpyralTM catheter, even the segmental small branches together with the main branches were ablated at a total of at least 16-18 points per side. Results: With the old method after RDN, SBP decreased by 40 mmHg and DBP by 20 mmHg. The reduction was greatest 1 month after the intervention, 45 and 35 mm Hg. But did not reach the goal values. With new method after RDN, SBP decreased by 38 mmHg and DBP by 27 mmHg. The reduction was greatest 1 month after the intervention, 49 and 37 mm Hg. With the new the SBP was already in the target range after the intervention and remained there for 6 months. In addition, the number of antihypertensives could be significantly reduced. With the old method the goal BP value could not be achieved. Vascular complications did not occur in either case of interventions. Conclusions: Our first result with the Symplicity SpyralTM catheter according to the new concepts supports the view that more accurate ablation and preferably distal ablation can lead to more effective blood pressure reduction.