Abstract
Introduction: SYMPLICITY HTN-3 trial did not show a significant reduction of BP in patients with resistant hypertension 6 months after renal artery denervation as compared with a sham control. Technical aspects of procedure could explain,in part,the negative findings of study e.g., the number and sites of delivery of energy are left to the operator's choice. Also, arterial wall contact was detectable only indirectly by a decrease in electric impedance, with the consequence that the success of the procedure may be operator-dependent. We present a case of renal denervation using a Multi-electrode catheter that resulted in a significant drop in BP in the1st month post procedure. Case Report: A 62-year-old man was referred with resistant hypertension. Medical history included IHD and T2DM. Treatment: Minoxidil 10mg BD; Amlodipine 10mg; Ramipril 10mg; Sotalol 160mg BD; Moxonidine 400mcg BD and frusemide 40mg. On examination, BP in left and right arm was 142/80 and 143/81mmHg respectively. Serial BP readings in the left arm were 143/87, 147/81 and 146/80mmHg. Secondary causes of HTN were excluded. Renal artery anatomy on CTA was suitable for denervation. Patient underwent renal denervation using the multi-electrode catheter. A total of 32 and 30 ablations were performed in the left and right renal system, respectively, within 25 minutes, as compared with 50-60minutes with 1st generation catheter. At one month, average BP was 135/73mmHg. Conclusion: Multi-electrode catheter provides a safe, effective and time-efficient method for renal artery denervation, which may overcome some of the technical difficulties associated with 1st generation catheter.
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