Open AccessRenal denervation beyond the bifurcation: The effect of distal ablation placement on safety and blood pressure
Author(s) -
Beeftink Martine M. A.,
Spiering Wilko,
De Jong Mark R.,
Doevendans Pieter A.,
Blankestijn Peter J.,
Elvan Arif,
Heeg JanEvert,
Bots Michiel L.,
Voskuil Michiel
Publication year - 2017
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12989
Subject(s) - medicine , denervation , blood pressure , renal artery , cardiology , lumen (anatomy) , artery , ambulatory blood pressure , kidney
Renal denervation may be more effective if performed distal in the renal artery because of smaller distances between the lumen and perivascular nerves. The authors reviewed the angiographic results of 97 patients and compared blood pressure reduction in relation to the location of the denervation. No significant differences in blood pressure reduction or complications were found between patient groups divided according to their spatial distribution of the ablations (proximal to the bifurcation in both arteries, distal to the bifurcation in one artery and distal in the other artery, or distal to the bifurcation in both arteries), but systolic ambulatory blood pressure reduction was significantly related to the number of distal ablations. No differences in adverse events were observed. In conclusion, we found no reason to believe that renal denervation distal to the bifurcation poses additional risks over the currently advised approach of proximal denervation, but improved efficacy remains to be conclusively established.