Abstract
A 38-year-old man with a history of resistant hypertension for more than 10 years underwent laparoscopic-based perivascular unilateral renal sympathetic nerve denervation in 2012. After the operation, the patient’s blood pressure has been controllable while the antihypertensive drug intake has decreased over 6 years. Laparoscopic-based perivascular unilateral renal sympathetic nerve denervation may be a potentially feasible and effective option in treating patients with resistant hypertension.
Highlights
Resistant hypertension is defined as blood pressure (BP) that does not remain within the normal range despite the administration of three antihypertensive medications at maximally tolerated doses, including a diuretic [1]
Two months before the surgery, the patient’s home BP was 195/115 mm Hg while taking five antihypertensive medications. For his poorly controlled BP, he was asked to increase the dosage of hydrochlorothiazide from 12.5 to 25 mg/day; spironolactone 20 mg bid was added as part of the treatment by a local physician, but his BP still stabilized at approximately 180/110 mm Hg
Catheter-based renal denervation (RDN) has been applied to treat resistant hypertension by ablating sympathetic nerves distributed in atrial wall from the intima of renal arteries [2]
Summary
Resistant hypertension is defined as blood pressure (BP) that does not remain within the normal range despite the administration of three antihypertensive medications at maximally tolerated doses, including a diuretic [1]. The patient was 172 cm tall and weighed 91.5 kg. He was taking five antihypertensive drugs: felodipine 5 mg/day, valsartan 80 mg/day, metoprolol 47.5 mg/day, hydrochlorothiazide 12.5 mg/day, and Laparoscopic-based perivascular unilateral renal sympathetic nerve denervation for treating resistant. Despite the medications, his BP on examination at the hospital was 206/118 mm Hg, while the 24-h BP was 172/108 mm Hg and home BP was 195/ 115 mm Hg. Despite the medications, his BP on examination at the hospital was 206/118 mm Hg, while the 24-h BP was 172/108 mm Hg and home BP was 195/ 115 mm Hg His BP and heart rate readings at different time points are provided in Table 1 and Fig. 1. The patient strongly wished to gain control of his BP lowering; there-
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