Abstract
BackgroundCatheter-based renal denervation (RDN) has been introduced to treat resistant hypertension. Although the technology of RDN has been largely improved, denervation of tortuous renal arteries remains challenging.Case presentationThis is a case report of a 49-year-old man with drug resistant hypertension. The patient was selected for RDN after ruling out possible causes of secondary hypertension. Computed tomography angiography showed a highly tortuous left renal artery. An Iberis multielectrode ablation catheter failed to reach the target vessel with a regular guiding catheter. A 5-French extension catheter was introduced into the proximal segment of the main left renal artery to provide extra support force, which enabled successful ablation of the highly tortuous left renal artery. His ambulatory blood pressure was significantly decreased at 1 month follow-up.ConclusionsIt is feasible and effective to use a guide extension catheter for denervation of highly tortuous renal arteries. The present study provides a useful method to ablate tortuous and angled renal arteries and branches.
Highlights
Catheter-based renal denervation (RDN) has been introduced to treat resistant hypertension
Renal sympathetic overactivity contributes to the development and maintenance of resistant hypertension
We present a RDN strategy for a highly tortuous renal artery using a guide extension catheter
Summary
It is feasible and effective to use a guide extension catheter for denervation of highly tortuous renal arteries.
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