Background: Renal sympathetic Denervation (RDN) is proved as an effective and safe for treatment resistant hypertension.
Aim: To evaluate the early, late effects and durability of RDN on BP in patients with resistant HTN in our two years experience
Methods: Inclusion Criteria: office SBP ≥160 mmHg on ≥3 anti-HTN medications, eGFR ≥45. Exclusion Criteria: Renal artery abnormalities, Type I-DM, MI, unstable angina, or CVA in prior 6 months, Pregnancy.
Results: 28 patients, 20 males, age 44-88 (62±11) years, eGFR 75±23, BMI 31±6. Patient were on 3-7 (4.5±0.9) antihypertension medications, 27 patients on ACEI and/or ARB, 24 on diuretics, 22 on Beta blockers, 20 on Ca Channel Blockers 10 on Doxazocin and 14 on Clonidine .
Procedure Detail & Safety: Procedure time 76±20 minutes, 4-8 (6.2±1) ablations per artery. Intravenous narcotics & sedatives used to manage pain during ablation. RDN was done bilaterally in 23 and unilaterally in 5 patients. No catheter or generator malfunctions, no vascular abnormalities at any site of RF delivery. No early or late major or minor complication except of one patient with prolonged renal artery spasm, treated with stent implantation and one with femoral puncture site major bleeding. No electrolyte disturbances or change in renal function. All patients, except one were discharged after overnight admission.
Effect of RDN: Two patient did'nt return to follow up, analysis done on 26. Significant clinical improvement in 20 of 26 patients. SBP decreased significantly (>10mmHg) in 25 of 26 patients (Fig-1). Baseline SBP was 185 ±13, decreased to 159 ±20, 147 ±15 , 143 ±15, 137 ±19, 140 ±23 @ 1, 3, 6, 12 and 18 months after RDN, respectively, p<0.001,(Fig-2).
Conclusions: Encouraging initial experience. RDN is feasible, safe, effective and durable
