Abstract
Introduction
Catheter-based renal sympathetic denervation is an emerging therapy for resistant hypertension (RHTN) patients, resulting in a significant blood pressure reduction. The presence of accessory renal arteries and anomalous branching patterns are reported in approximately 20–27 % of patients. However, accessory renal arteries, when smaller than 4 mm in diameter, they are out of the inclusion criteria for renal denervation therapy. For this reason patients with evidence of accessory renal arteries have been excluded in previous clinical trials. Recent data suggest that accessory renal arteries may play an important role in non-response therapy when they do not receive renal denervation treatment.
Case Report
In this report, we present the outcome of a patient with resistant hypertension and an anomalous right renal artery, having undergone denervation of both principal and accessory renal arteries. The renal ablation by radiofrequency energy of a distant accessory renal artery resulted in a safe procedure with no clinical complications.
Conclusion
Consistent with literature the RDN of all, main and accessory renal arteries, was effective in decreasing patient blood pressure while decreasing the need for antihypertensive medication.
References
Nemoto N, Hamann J, Lesser J, Schwartz R. Renal denervation in patients with accessory renal arteries: renal mass is directly proportional to total renal artery cross sectional area and implications for therapy. J Am Coll Cardiol. 2014;63(12_S). doi:10.1016/S0735-1097(14)62087-8.
Castro Torres Y, Katholi RE. Renal denervation for treating resistant hypertension: current evidence and future insights from a global perspective. Int J Hypertens. 2013;2013:513214.
Satyapal KS, Haffejee AA, Singh B, Ramsaroop L, Robbs JV, Kalideen JM. Additional renal arteries: incidence and morphometry. Surg Radiol Anat. 2001;23(1):33–8.
Gupta A, Tello R. Accessory renal arteries are not related to hypertension risk: a review of MR angiography data. AJR. 2004;182(6):1521–4.
Id D, Kaltenbach B, Bertog SC, Hornung M, Hofmann I, Vaskelyte L, Sievert H. Does the presence of accessory renal arteries affect the efficacy of renal denervation? JACC Cardiovasc Interv. 2013;6(10):1085–91.
Kumar MP, Suseelamma D, Saritha S, Lingaswamy V. Multiple renal vascular variations. Open Access Sci Rep. 2012;1:334. doi:10.4172/scientificreports.334.
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No conflicts of interest, financial or otherwise, are declared by the authors.
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de Leon-Martinez, E.P., Garza, J.A., Azpiri-Lopez, J.R. et al. Safety and Clinical Outcome of the Delivery of Radiofrequency Nerve Ablation Therapy in a Renal Artery of Unusual Anatomy. High Blood Press Cardiovasc Prev 22, 445–448 (2015). https://doi.org/10.1007/s40292-015-0107-2
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DOI: https://doi.org/10.1007/s40292-015-0107-2