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Does Renal Artery Supply Indicate Treatment Success of Renal Denervation?

  • Clinical Investigation
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Abstract

Purpose

Renal denervation (RDN) emerged as an innovative interventional antihypertensive therapy. With the exception of pretreatment blood pressure (BP) level, no other clear predictor for treatment efficacy is yet known. We analyzed whether the presence of multiple renal arteries has an impact on BP reduction after RDN.

Methods

Fifty-three patients with treatment-resistant hypertension (office BP ≥ 140/90 mmHg and 24-h ambulatory BP monitoring (≥130/80 mmHg) underwent bilateral catheter-based RDN. Patients were stratified into one-vessel (OV) (both sides) and at least multivessel (MV) supply at one side. Both groups were treated on one vessel at each side; in case of multiple arteries, only the dominant artery was treated on each side.

Results

Baseline clinical characteristics (including BP, age, and estimated glomerular filtration rate) did not differ between patients with OV (n = 32) and MV (n = 21). Office BP was significantly reduced in both groups at 3 months (systolic: OV −15 ± 23 vs. MV −16 ± 20 mmHg; diastolic: OV −10 ± 12 vs. MV −8 ± 11 mmHg, both p = NS) as well as 6 months (systolic: OV −18 ± 18 vs. MV −17 ± 22 mmHg; diastolic: OV −10 ± 10 vs. −10 ± 12 mmHg, both p = NS) after RDN. There was no difference in responder rate (rate of patients with office systolic BP reduction of at least 10 mmHg after 6 months) between the groups.

Conclusion

In patients with multiple renal arteries, RDN of one renal artery—namely, the dominant one—is sufficient to induce BP reduction in treatment-resistant hypertension.

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Acknowledgments

We gratefully acknowledge the expert technical assistance of Ulrike Höfer and the assistant personnel of the angiography laboratory.

Conflict of interest

A.S. has received lecture fees from Medtronic Inc., P.A.S. was an employee of Medtronic Inc., and R.E.S. has received grants, performed lectures, and received consultancy fees from Medtronic Inc. The other authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany

    Axel Schmid & Michael Uder

  2. Department of Nephrology and Hypertension, University of Erlangen-Nuremberg, Erlangen, Germany

    Tilmann Ditting, Roland Veelken, Roland E. Schmieder & Christian Ott

  3. Ohio State University, Columbus, OH, USA

    Paul A. Sobotka

  4. Coridea-NC1, New York, NY, USA

    Paul A. Sobotka

Authors
  1. Axel Schmid
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  2. Tilmann Ditting
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  3. Paul A. Sobotka
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  4. Roland Veelken
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  5. Roland E. Schmieder
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  6. Michael Uder
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  7. Christian Ott
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Corresponding author

Correspondence to Axel Schmid.

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Schmid, A., Ditting, T., Sobotka, P.A. et al. Does Renal Artery Supply Indicate Treatment Success of Renal Denervation?. Cardiovasc Intervent Radiol 36, 987–991 (2013). https://doi.org/10.1007/s00270-013-0652-9

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  • DOI: https://doi.org/10.1007/s00270-013-0652-9

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