Renal denervation beyond the bifurcation: The effect of distal ablation placement on safety and blood pressure |
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| Authors: | Martine M A Beeftink MD Wilko Spiering MD PhD Mark R De Jong MD Pieter A Doevendans MD PhD Peter J Blankestijn MD PhD Arif Elvan MD PhD Jan‐Evert Heeg MD PhD Michiel L Bots MD PhD Michiel Voskuil MD PhD |
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| Institution: | 1. Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands;2. Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands;3. Department of Cardiology, Isala Hospital, Zwolle, the Netherlands;4. Department of Nephrology, University Medical Center Utrecht, Utrecht, the Netherlands;5. Department of Internal Medicine, Isala Hospital, Zwolle, the Netherlands;6. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands |
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| Abstract: | Renal denervation may be more effective if performed distal in the renal artery because of smaller distances between the lumen and perivascular nerves. The authors reviewed the angiographic results of 97 patients and compared blood pressure reduction in relation to the location of the denervation. No significant differences in blood pressure reduction or complications were found between patient groups divided according to their spatial distribution of the ablations (proximal to the bifurcation in both arteries, distal to the bifurcation in one artery and distal in the other artery, or distal to the bifurcation in both arteries), but systolic ambulatory blood pressure reduction was significantly related to the number of distal ablations. No differences in adverse events were observed. In conclusion, we found no reason to believe that renal denervation distal to the bifurcation poses additional risks over the currently advised approach of proximal denervation, but improved efficacy remains to be conclusively established. |
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| Keywords: | hypertension— general optimized treatment renal denervation |
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