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Safety of Renal Denervation

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Book cover Interventional Therapies for Secondary and Essential Hypertension

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

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Abstract

As catheter-based renal denervation (RDN) has been a recently introduced invasive treatment, confirming the safety of the procedure has been a central issue in the conducted trials. Preclinical data have identified limited changes in the vessel wall including local oedema, thrombus formation and fibrosis. Clinical trials reported only few periprocedural adverse events such as access site complications and renal artery dissections, while follow-up of patients for up to 3 years showed that this is an overall safe procedure. Adverse events potentially associated with autonomic dysfunction, such as orthostatic hypotension, have been rare and in general not associated with RDN. A number of reports on new renal artery stenosis, theoretically associated with the radiofrequency-induced tissue injury, have raised concerns for such a complication, even though the relative incidence is notably small. In trials with different catheters as well as running registries, renal function has been shown to remain stable or mildly deteriorate. Thorough recording of events in all studies as well as comparisons of safety among current and developing devices are pivotal in order to provide a clearer picture of long-term safety.

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Abbreviations

BP:

Blood pressure

CT:

Computed tomography

dRHT:

Drug-resistant hypertension

eGFR:

Estimated glomerular filtration rate

HTN:

Hypertension

MR:

Magnetic resonance

OCT:

Optical coherence tomography

RDN:

Renal denervation

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Authors and Affiliations

  1. First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece

    Costas Thomopoulos MD, PhD, Alexandros Kasiakogias MD, PhD & Ioannis Kallikazaros MD, PhD

  2. 1st Cardiology Clinic, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece

    Costas Tsioufis MD, PhD

Authors
  1. Costas Thomopoulos MD, PhD
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  2. Alexandros Kasiakogias MD, PhD
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  3. Ioannis Kallikazaros MD, PhD
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  4. Costas Tsioufis MD, PhD
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Correspondence to Costas Tsioufis MD, PhD .

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Editors and Affiliations

  1. First Cardiology Clinic, National and Kapodistrian University of Athens, Athens, Greece

    Costas Tsioufis

  2. Department of Nephrology and Hypertension, University Hospital Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

    Roland E. Schmieder

  3. IRCCS Istituto Auxologico Italiano, University Milano-Bicocca, Milano Monza, Italy

    Giuseppe Mancia

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Thomopoulos, C., Kasiakogias, A., Kallikazaros, I., Tsioufis, C. (2016). Safety of Renal Denervation. In: Tsioufis, C., Schmieder, R., Mancia, G. (eds) Interventional Therapies for Secondary and Essential Hypertension. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-34141-5_15

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  • DOI: https://doi.org/10.1007/978-3-319-34141-5_15

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