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Anatomical and procedural determinants of catheter-based renal denervation

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Anatomical and procedural determinants of catheter-based renal denervation. / Ewen, Sebastian; Ukena, Christian; Lüscher, Thomas Felix; Bergmann, Martin; Blankestijn, Peter J; Blessing, Erwin; Cremers, Bodo; Dörr, Oliver; Hering, Dagmara; Kaiser, Lukas; Nef, Holger; Noory, Elias; Schlaich, Markus; Sharif, Faisal; Sudano, Isabella; Vogel, Britta; Voskuil, Michiel; Zeller, Thomas; Tzafriri, Abraham R; Edelman, Elazer R; Lauder, Lucas; Scheller, Bruno; Böhm, Michael; Mahfoud, Felix.

in: CARDIOVASC REVASCULA, Jahrgang 17, Nr. 7, 13.09.2016, S. 474-479.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Ewen, S, Ukena, C, Lüscher, TF, Bergmann, M, Blankestijn, PJ, Blessing, E, Cremers, B, Dörr, O, Hering, D, Kaiser, L, Nef, H, Noory, E, Schlaich, M, Sharif, F, Sudano, I, Vogel, B, Voskuil, M, Zeller, T, Tzafriri, AR, Edelman, ER, Lauder, L, Scheller, B, Böhm, M & Mahfoud, F 2016, 'Anatomical and procedural determinants of catheter-based renal denervation', CARDIOVASC REVASCULA, Jg. 17, Nr. 7, S. 474-479. https://doi.org/10.1016/j.carrev.2016.08.004

APA

Ewen, S., Ukena, C., Lüscher, T. F., Bergmann, M., Blankestijn, P. J., Blessing, E., Cremers, B., Dörr, O., Hering, D., Kaiser, L., Nef, H., Noory, E., Schlaich, M., Sharif, F., Sudano, I., Vogel, B., Voskuil, M., Zeller, T., Tzafriri, A. R., ... Mahfoud, F. (2016). Anatomical and procedural determinants of catheter-based renal denervation. CARDIOVASC REVASCULA, 17(7), 474-479. https://doi.org/10.1016/j.carrev.2016.08.004

Vancouver

Ewen S, Ukena C, Lüscher TF, Bergmann M, Blankestijn PJ, Blessing E et al. Anatomical and procedural determinants of catheter-based renal denervation. CARDIOVASC REVASCULA. 2016 Sep 13;17(7):474-479. https://doi.org/10.1016/j.carrev.2016.08.004

Bibtex

@article{7e5a2a59e76448b598c15d3c2d59a138,
title = "Anatomical and procedural determinants of catheter-based renal denervation",
abstract = "BACKGROUND/PURPOSE: Catheter-based renal sympathetic denervation (RDN) can reduce blood pressure (BP) and sympathetic activity in certain patients with uncontrolled hypertension. Less is known about the impact of renal anatomy and procedural parameters on subsequent BP response.METHODS/MATERIALS: A total of 564 patients with resistant hypertension underwent bilateral RDN in 9 centers in Europe and Australia using a mono-electrode radiofrequency catheter (Symplicity Flex, Medtronic). Anatomical criteria such as prevalence of accessory renal arteries (ARA), presence of renal artery disease (RAD), length, and diameter were analyzed blinded to patient's characteristics.RESULTS: ARA was present in 171 patients (30%), and RAD was documented in 71 patients (13%). On average 11±2.7 complete 120-s ablations were performed, equally distributed on both sides. After 6months, BP was reduced by 19/8mmHg (p<0.001 for both). Change of systolic blood pressure (SBP) was not related to the presence of ARA (-18 vs. -20mmHg; p=NS) or RAD (-16 vs. -20mmHg; p=NS). Patients with a bilateral diameter≤4mm had a more pronounced reduction of SBP compared to patients with a unilateral diameter≤4mm or a bilateral diameter>4mm (-29 vs. -26 vs. -17mmHg; p<0.001). Neither the length of the renal artery nor the number of RF ablations influenced BP reduction after 6months.CONCLUSIONS: The diameter of renal arteries correlated with SBP change after RDN at 6-month follow-up. Change of SBP was not related to the lengths of the renal artery, presence of ARA, RAD, or the number of RF ablations delivered by a mono-electrode catheter.",
keywords = "Aged, Antihypertensive Agents/therapeutic use, Australia, Blood Pressure/drug effects, Catheter Ablation, Drug Resistance, Europe, Female, Humans, Hypertension/complications, Kidney/blood supply, Male, Middle Aged, Prospective Studies, Renal Artery/abnormalities, Sympathectomy/methods, Treatment Outcome, Vascular Malformations/complications",
author = "Sebastian Ewen and Christian Ukena and L{\"u}scher, {Thomas Felix} and Martin Bergmann and Blankestijn, {Peter J} and Erwin Blessing and Bodo Cremers and Oliver D{\"o}rr and Dagmara Hering and Lukas Kaiser and Holger Nef and Elias Noory and Markus Schlaich and Faisal Sharif and Isabella Sudano and Britta Vogel and Michiel Voskuil and Thomas Zeller and Tzafriri, {Abraham R} and Edelman, {Elazer R} and Lucas Lauder and Bruno Scheller and Michael B{\"o}hm and Felix Mahfoud",
note = "Copyright {\textcopyright} 2016 Elsevier Inc. All rights reserved.",
year = "2016",
month = sep,
day = "13",
doi = "10.1016/j.carrev.2016.08.004",
language = "English",
volume = "17",
pages = "474--479",
journal = "CARDIOVASC REVASCULA",
issn = "1553-8389",
publisher = "Elsevier Inc.",
number = "7",

}

RIS

TY - JOUR

T1 - Anatomical and procedural determinants of catheter-based renal denervation

AU - Ewen, Sebastian

AU - Ukena, Christian

AU - Lüscher, Thomas Felix

AU - Bergmann, Martin

AU - Blankestijn, Peter J

AU - Blessing, Erwin

AU - Cremers, Bodo

AU - Dörr, Oliver

AU - Hering, Dagmara

AU - Kaiser, Lukas

AU - Nef, Holger

AU - Noory, Elias

AU - Schlaich, Markus

AU - Sharif, Faisal

AU - Sudano, Isabella

AU - Vogel, Britta

AU - Voskuil, Michiel

AU - Zeller, Thomas

AU - Tzafriri, Abraham R

AU - Edelman, Elazer R

AU - Lauder, Lucas

AU - Scheller, Bruno

AU - Böhm, Michael

AU - Mahfoud, Felix

N1 - Copyright © 2016 Elsevier Inc. All rights reserved.

PY - 2016/9/13

Y1 - 2016/9/13

N2 - BACKGROUND/PURPOSE: Catheter-based renal sympathetic denervation (RDN) can reduce blood pressure (BP) and sympathetic activity in certain patients with uncontrolled hypertension. Less is known about the impact of renal anatomy and procedural parameters on subsequent BP response.METHODS/MATERIALS: A total of 564 patients with resistant hypertension underwent bilateral RDN in 9 centers in Europe and Australia using a mono-electrode radiofrequency catheter (Symplicity Flex, Medtronic). Anatomical criteria such as prevalence of accessory renal arteries (ARA), presence of renal artery disease (RAD), length, and diameter were analyzed blinded to patient's characteristics.RESULTS: ARA was present in 171 patients (30%), and RAD was documented in 71 patients (13%). On average 11±2.7 complete 120-s ablations were performed, equally distributed on both sides. After 6months, BP was reduced by 19/8mmHg (p<0.001 for both). Change of systolic blood pressure (SBP) was not related to the presence of ARA (-18 vs. -20mmHg; p=NS) or RAD (-16 vs. -20mmHg; p=NS). Patients with a bilateral diameter≤4mm had a more pronounced reduction of SBP compared to patients with a unilateral diameter≤4mm or a bilateral diameter>4mm (-29 vs. -26 vs. -17mmHg; p<0.001). Neither the length of the renal artery nor the number of RF ablations influenced BP reduction after 6months.CONCLUSIONS: The diameter of renal arteries correlated with SBP change after RDN at 6-month follow-up. Change of SBP was not related to the lengths of the renal artery, presence of ARA, RAD, or the number of RF ablations delivered by a mono-electrode catheter.

AB - BACKGROUND/PURPOSE: Catheter-based renal sympathetic denervation (RDN) can reduce blood pressure (BP) and sympathetic activity in certain patients with uncontrolled hypertension. Less is known about the impact of renal anatomy and procedural parameters on subsequent BP response.METHODS/MATERIALS: A total of 564 patients with resistant hypertension underwent bilateral RDN in 9 centers in Europe and Australia using a mono-electrode radiofrequency catheter (Symplicity Flex, Medtronic). Anatomical criteria such as prevalence of accessory renal arteries (ARA), presence of renal artery disease (RAD), length, and diameter were analyzed blinded to patient's characteristics.RESULTS: ARA was present in 171 patients (30%), and RAD was documented in 71 patients (13%). On average 11±2.7 complete 120-s ablations were performed, equally distributed on both sides. After 6months, BP was reduced by 19/8mmHg (p<0.001 for both). Change of systolic blood pressure (SBP) was not related to the presence of ARA (-18 vs. -20mmHg; p=NS) or RAD (-16 vs. -20mmHg; p=NS). Patients with a bilateral diameter≤4mm had a more pronounced reduction of SBP compared to patients with a unilateral diameter≤4mm or a bilateral diameter>4mm (-29 vs. -26 vs. -17mmHg; p<0.001). Neither the length of the renal artery nor the number of RF ablations influenced BP reduction after 6months.CONCLUSIONS: The diameter of renal arteries correlated with SBP change after RDN at 6-month follow-up. Change of SBP was not related to the lengths of the renal artery, presence of ARA, RAD, or the number of RF ablations delivered by a mono-electrode catheter.

KW - Aged

KW - Antihypertensive Agents/therapeutic use

KW - Australia

KW - Blood Pressure/drug effects

KW - Catheter Ablation

KW - Drug Resistance

KW - Europe

KW - Female

KW - Humans

KW - Hypertension/complications

KW - Kidney/blood supply

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Renal Artery/abnormalities

KW - Sympathectomy/methods

KW - Treatment Outcome

KW - Vascular Malformations/complications

U2 - 10.1016/j.carrev.2016.08.004

DO - 10.1016/j.carrev.2016.08.004

M3 - SCORING: Journal article

C2 - 27617388

VL - 17

SP - 474

EP - 479

JO - CARDIOVASC REVASCULA

JF - CARDIOVASC REVASCULA

SN - 1553-8389

IS - 7

ER -