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Long-term follow-up of renal arteries after radio-frequency catheter-based denervation using optical coherence tomography and angiography
Authors:Tomasz Roleder  Mariusz Skowerski  Andrzej Wiecek  Marcin Adamczak  Beata Czerwienska  Wojciech Wanha  Tomasz Jadczyk  Lukasz Partyka  Grzegorz Smolka  Wacław Kuczmik  Andrzej Ochała  Dariusz Dudek  Michał Tendera  Zbigniew Gasior  Wojciech Wojakowski
Institution:1.Chair and Department of Cardiology,Medical University of Silesia,Katowice,Poland;2.Department of Nephrology, Transplantology, and Internal Diseases,Medical University of Silesia,Katowice,Poland;3.Third Department of Cardiology,Medical University of Silesia,Katowice,Poland;4.Krakow Cardiovascular Research Institute,Krakow,Poland;5.Institute of Cardiology,Jagiellonian University Medical College,Krakow,Poland;6.Division of Vascular Surgery,Medical University of Silesia,Katowice,Poland
Abstract:Optical coherence tomography (OCT) imaging at the time of renal denervation (RDN) showed that procedure might cause spasm, intimal injury or thrombus formation. In the present study, we assessed the healing of renal arteries after RDN using OCT and renal angiography in long-term follow-up. OCT and renal angiography were performed in 12 patients (22 arteries) 18.41 ± 5.83 months after RNS. There were no adverse events or complications during the long-term follow-up. In ten patients (83 %), significant reductions of blood pressure was achieved without a change of the antihypertensive medications. We demonstrated the presence of 26 areas of focal intimal thickening identified by OCT in 10 (83 %) patients and in 14 (63 %) arteries. The mean area of focal intimal thickening was 0.054 ± 0.033 mm2. No vessel dissection, thrombus, intimal tear or acute vasospasm were observed during the OCT analysis. Also, the quantitative angiography analysis revealed a significant reduction of the minimal and proximal lumen diameters at follow-up as compared to measurements obtained before RDN. Renal arteries have a favorable “long-term” vessel healing response after RDN. Focal intimal thickening and a modest reduction of the minimal lumen diameter may be observed after RF denervation. Further studies are needed to determine whether intravascular imaging may be helpful in evaluating the vessel healing of RF RDN.
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