RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION: FOLLOW UP 2011-2021 OF THE SERIES OF THE ESH CENTER OF EXCELLENCE IN TURIN

Abstract

Objective: Renal denervation (DRN) is one of the invasive therapeutic approaches of resistant arterial hypertension. The aim of this study was to re-evaluate patients undergoing DRN, in terms of safety and efficacy. Design and method: A retrospective evaluation of patients undergoing DRN between 01/01/2011 and 31/12/2021 in the Arterial Hypertension Center of Turin. Results: The series included 14 subjects, of which 8 (57%) were female and with an average age 54±10 years. The number of antihypertensive drugs before renal denervation was 5.7±1.0 and at baseline the blood pressure was 188/113±22±18 mmHg. 28% of subjects had a history of ischemic heart disease and 27% of previous stroke and/or transient ischemic event. 9 subjects were denervated with Symplicity device, 1 with Vessix, 4 with Symplicity Spyral. The mean duration of follow-up was 5.2 years. From a safety point of view, there were no short-term or long-term complications. In terms of efficacy, the number of responders at 6 months, defined as a reduction of at least 10 mmHg in systolic blood pressure (PAS) at 24h Blood Pressure Monitoring, was 9 subjects (64%). Two subjects reported systolic blood pressure values below 135 mmHg. Regarding the type of device used, 75% of subjects treated with Spiral devices were responders, compared with 60% of subjects treated with other catheters. Among the non-responders, 2 presented events one year after the DRN. Only 1 responder had high level of renin at baseline. Conclusions: The data relating to the case studies of the Arterial Hypertension Center of Turin highlight the safety of the renal denervation procedure and a blood pressure response in 60% of patients. The latest generation catheters seems to be more effective. However, the small number of cases did not allow to identify predictive factors of response to DRN.