Safety Of Radiofrequency Renal Denervation Research Articles

The use of CO2 to create an optical window during intravascular optical coherence tomography in a patient with an allergic reaction to iodine contrast

A necessary condition for obtaining a high-quality image with optical coherence tomography (OCT) is the displacement of blood from the visualized segment of the vessel to provide a transparent medium between the vascular wall and the photo detector. Traditionally, liquid iodine-containing contrast is used for this, which can be dangerous in patients with iodine allergy or renal insufficiency. We present a clinical case of successful OCT using CO2 in a patient with anaphylactic reaction to iodine-containing contrast. OCT was performed to monitor the safety of radiofrequency renal denervation. CO2 was injected as standard into a guide catheter located in the renal artery. With the help of CO2, it was possible to effectively displace blood from the renal artery and obtain high-quality OCT images of the vascular wall microstructure.

Radiofrequency renal denervation with mono-electrode and multi-electrode device for treatment in patient with uncontrolled hypertension: results of a 6-month follow-up

Aim. To study the efficacy and safety of radiofrequency renal denervation with mono-electrode and multi-electrode devices in patients with uncontrolled arterial hypertension during а 6-month follow-up period.
 Materials and methods. The study included 52 patients with uncontrolled arterial hypertension, while receiving multicomponent antihypertensive therapy, including diuretic. Patients underwent radiofrequency renal denervation with a mono-electrode (group A; n=27) and multi-electrode devices (group B; n=25). The effectiveness of the procedure was study according to office blood pressure (BP) and ambulatory blood pressure monitoring (ABPM).
 Results. In group A and B, according to office BP after 6 months, there decreased in SBP/DBP by 32/14 and 30/10 mmHg (р=0.00001/р=0.00001 and p=0.00001/0.0004) respectively. According to ABPM, in group A there was a decrease in the average daily SBP and DBP by 7 and 4 mmHg (р=0.01 and р=0.03) respectively. According to ABPM, after 6 months in group B, there was a decrease in the average daily SBP and DBP by 12 and 6 mmHg (р=0.0003 and р=0.0007) respectively.
 Conclusions. The results confirm the safety and effectiveness of radiofrequency renal denervation. RDN of the distal branches of the renal arteries leads to a greater hypotensive effect.

RADIAL ACCESS FOR RADIOFREQUENCY RENAL DENERVATION IN PATIENTS WITH RESISTANT HYPERTENSION

Objective:To study the practicability and safety of radiofrequency renal denervation using radial arterial access (RAA) in comparison with femoral arterial access (FAA). FAA is associated with different complications such as groin hematomas, pseudoaneurysm, arteriovenous fistula, thrombosis, neural

Radiofrequency renal denervation with different device for treatment in patient with uncontrolled hypertension

Objective. To study the efficacy and safety of radiofrequency renal denervation with mono-electrode and multi-electrode devices in patients with uncontrolled arterial hypertension during follow-up period. Materials and methods. The study included 42 patients with uncontrolled arterial hypertension (mean age 51±12 years), while receiving multicomponent antihypertensive therapy, including diuretic. All patients underwent radiofrequency denervation of the renal arteries with a mono-electrode (n=27; group A) and multi-electrode devices (n=15; group B). The safety of the procedure was assessed using creatinine and glomerular filtration rate (MDRD equation), as well as according to ultrasound of the kidneys and renal arteries. The effectiveness of the procedure was study according to office blood pressure (BP) and ambulatory BP monitoring (ABPM). Results. In the general group, according to office BP after 6 months, there decreased in systolic (SBP)/diastolic BP (DBP) by 28/13 mm Hg (p=0.000001). According to ABPM, there was a decrease in the average daily SBP by 9 mm Hg (p=0.007) and DBP by 6 mm Hg (p=0.03). No significant changes in creatinine and glomerular filtration rate were detected in the general group. According to ABPM, after 6 months in group B, there was a decrease in the average daily SBP/DBP by 13 and 6 mm Hg (p=0.1). In group A, according to the ABPM, after 6 months, there was a decrease in the average daily SBP and DBP by 7 mm Hg (p=0.001) and 4 mm Hg (p=0.03). After 1 year, according to the office BP, there was a decrease in SBP/DBP by 14/11 mm Hg (p=0.002), and after 3 years at 15/17 mm Hg (p=0.3). Conclusion. The results confirm the safety and efficacy of radiofrequency renal denervation. Renal denervation in combination with drug therapy leads to decreasing of BP after 6 months and in the long-term