Renal arteries denervation with second generation systems: a remedy for resistant hypertension?. (18th November 2020)

• Record Type: Journal Article
• Authors: Versaci, Francesco; Sciarretta, Sebastiano; Scappaticci, Massimiliano; Calcagno, Simone; di Pietro, Riccardo; Sbandi, Francesca; Dei Giudici, Angela; Del Prete, Armando; de Angelis, Stefano; Biondi-Zoccai, Giuseppe
• Is Part Of: European heart journal supplements. Volume 22(2020)Supplement L
• Page Start: L160
• Page End: L165
• Publication Date: 2020-11-18
• Subjects: Arterial hypertension -- Renal arteries -- Sympathetic nervous system; Cardiology -- Periodicals; Cardiology -- Europe -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/suaa158
• Languages: English
• ISSNs: 1520-765X

Abstract

Abstract: Initial studies on renal denervation (RDN) for the treatment of non-controlled arterial hypertension (HTN) through radiofrequency ablation of renal arteries demonstrated that RDN is an effective therapeutic strategy to reduce arterial blood pressure (BP). Nonetheless, the first randomized study, SYMPLICITY-HTN-3, failed to demonstrate a clear benefit for RND over the control group. Technologic evolution, with the introduction of new second generation multi-electrode devices, allowed deep energy delivery along the full circumference of the vessel. Two recent randomized studies involving patients assuming (SPYRAL HTN-ON MED) or not (SPYRAL HTN-OFF MED) antihypertensive pharmacologic treatment, demonstrated the efficacy and safety of RDN using second generation systems for radiofrequency ablation. Another recent randomized study demonstrated that RDN with ultrasounds (RADIANCE-HTN SOLO) of the main renal arteries led to a significant BP reduction compared to the control group. These studies have once again raised the interest of the scientific community towards attempting to define the appropriate role of RDN in the treatment of hypertension. Nonetheless, larger and longer clinical trials will be necessary to draw further conclusions.