Renal sympathetic denervation in patients with aortic dissection

We report on feasibility, safety, and mid-term outcomes of renal sympathetic denervation (RSD) in hypertensive patients after endovascular treatment for aortic dissection.

Six patients were subjected to RSD after receiving endovascular treatment for complicated aortic dissection. Between April 2011 and May 2012, RSD procedure was applied for persistent hypertension despite maximized antihypertensive drug therapy using the Symplicity® catheter system. Endovascular aortic treatment was performed for malperfusion or rapid expansion by virtue of a stent-graft system (Valiant®, n = 5) or an open cell stent (Smart®; n = 1).

Systolic blood pressure (BP) was 189.8 ± 32.2 mmHg and diastolic BP 96.2 ± 11.1 mmHg at baseline on 24 hours readings; after RSD, a successful reduction to 129.5 ± 11.8 mmHg (P = 0.004) for systolic and to 77.7 ± 10.7 (P = 0.004) for diastolic BP at 3-month follow-up was documented on ambulatory 24-hour BP readings with sustained reduction at 1-year follow-up (127.2 ± 11.8 mmHg [P = 0.002] and 77.7 ± 7.7 [P = 0.011]).

RSD using the Symplicity® catheter system is feasible and safe in hypertensive patients previously subjected to endovascular repair for complicated aortic dissection.