OP-105 RENAL SYMPATHETIC DENERVATION FOR RESISTANT HYPERTENSION AND DOUBLE LEFT RENAL ARTERY ABLATION

Abstract

Background: Hypertension is a major global health problem. An estimated 25–30% of the adult population in the world suffer from this condition. Resistant hypertension is defined as when a treatment that has included attention to lifestyle measures and the prescription of at least three drugs (including a diuretic) in adequate doses has failed to lower systolic and diastolic blood pressure to goal. Prevalence of resistant hypertension is nearly 10%. Percutaneous renal sympathetic denervation is a novel approach for resistant hypertension treatment. Method: Renal sympathetic denervation was performed for three patients who had resistant hypertension. For renal denervation first of all renal arteries canulate with 6F guidewire (RDC-I, Vista britetip, Cordis, FL, USA), then we performed renal angiography and showed that renal arteries size (diameter >4mm, length >30mm). We performed renal denervation with renal denervation catheter (RDN 006, Symplicity Catheter, Ardian, Inc, USA). The third patient had double left renal artery (Figure 1); we performed renal denervation for both left renal artery. At the end of the denervation we performed renal angiography and showed the denervation points. Results: Patients characteristics, treatment, procedural characteristics, plasma renin activity and norepinephrine values are shown in Table 1. Three patients were followed in terms of blood pressure and complications for 6 months and we achieved target blood pressure for the first and second patients and the number of antihypertensive drugs were reduced (the antihypertensive drug number reduced from 6 to 3 for the first patient and reduced from 6 to 4 for the second patient) (Table 1). We have not achieved target blood pressure for the third patient yet. Conclusion: Renal denervation was performed successfuly and blood pressure was significantly decreased in patients with resistance hypertension. More data are needed to investigate the usefulness of renal denervation procedure in the management of the double renal artery.