J Korean Med Sci.  2013 Jun;28(6):951-954. 10.3346/jkms.2013.28.6.951.

Percutaneous Renal Sympathetic Denervation for the Treatment of Resistant Hypertension with Heart Failure: First Experience in Korea

• Yang JH
• Choi SH
• Gwon HC

• KMID: 2158047
• DOI: http://doi.org/10.3346/jkms.2013.28.6.951

Abstract

Percutaneous catheter-based therapy has recently been introduced to decrease blood pressure by ablation of efferent and afferent sympathetic renal nerves. The patient described here had a seven-year history of hypertension and presented with poorly controlled blood pressure despite antihypertensive therapy with four different drugs. A 44-yr-old man underwent percutaneous renal denervation under local anesthesia using an ablation catheter. After six months of follow-up his blood pressure had dropped 49/37 mmHg with a decrease in 24-hr ambulatory BP of 20/18 mmHg. Renal Doppler ultrasound showed no significant stenosis in either renal artery. This is the first case of successful percutaneous renal denervation, which has recently become available in Korea.

Keyword

Resistant Hypertension; Renal Sympathetic Denervation

MeSH Terms

Adult
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Heart Failure/complications
Humans
Hypertension/complications/*surgery
Kidney/ultrasonography
Male
Renal Artery/radiography
Republic of Korea
Sympathectomy

Figure

• 

  Fig. 1 Monitoring of 24-hr ambulatory blood pressure (BP). (A) At baseline showing poorly controlled BP (average systolic/diastolic BP = 167/113 mm Hg). (B) After 6 months of follow-up showing suboptimally-controlled BP (average systolic/diastolic BP = 147/95 mmHg).

• 

  Fig. 2 Renal angiographies baseline image showing no significant stenosis in the left (A) or right renal artery (D). While the catheter was withdrawn proximally, five radiofrequency ablations were delivered to the left renal artery (B) while six were delivered to the right renal artery (E). Final angiographic findings were acceptable and did not show any complications in the left (C) or right renal artery (F).

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