Patients with hypertension after renal artery stenting who are not responsive to medications may have the option of renal sympathetic denervation to lower blood pressure.
Patients with hypertension after renal artery stenting who are not responsive to medications may have the option of renal sympathetic denervation to lower blood pressure by desensitizing nerve endings in the vascular wall, according to a proof-of-concept study published in the Journal of Endovascular Therapy.
Yvonne Bausback, MD, and colleagues studied 10 patients with renal artery stents who were treated with radiofrequency renal denervation and followed for 12 months after the procedure. The study examined office blood pressure and ambulatory blood pressure measurements, medication, and renal assessment at baseline and at 3, 6, and 12 months.
A successful response to treatment was considered a reduction of at least 10 mm Hg in office blood pressure as well as renal artery patency. Nine of the 10 patients met this goal, showing sustained decreased readings in office blood pressure from baseline to 3, 6, and 12 months. Initial readings averaging approximately 190/84 mm Hg declined to 158/76 mm Hg after 12 months.
No renal artery restenosis or aneurysm occurred at 1 year.
An accompanying commentary in the journal notes that other trials of this procedure have not met with the same success, and the recently released 6-month results of the SYMPLICITY HTN-3 trial showed no significant differences between renal denervation and a sham procedure. The commentary urges a case-by-case consideration for renal denervation while further research is conducted.