Transradial renal denervation for the treatment of resistant hypertension

As a novel device-based approach targeting the renal sympathetic nerves, renal denervation has been shown to be effective and safe in reducing blood pressure. The femoral artery is currently the most common access site for this procedure due to catheter profile and length limitations that restrict the use of radial access. The purpose of this study was to evaluate technical feasibility and short-term outcomes of transradial renal denervation by a longer radiofrequency ablation catheter (155 cm; AngioCare).

Five patients (mean age, 46 ± 15 years; 3 male) with resistant hypertension underwent successful transradial renal denervation (3 right, 2 left) at our institution from April to June, 2013. In this group, 3 patients were excluded from femoral access due to an acute aorto-renal angle, or severe tortuosity of the abdominal aorta and iliac arteries. All 5 patients were followed at 1 month and 3 months post procedure. Blood pressure, use of antihypertensive agents, renal function, and complications were investigated.

The mean reduction of 24-hour ambulatory blood pressure was -13/-8 mm Hg at 1-month and -20/-12 mm Hg at 3-month follow-up exam (P<.05, compared with baseline) with unchanged antihypertensive drugs. There was no significant change of renal function at 3-month follow-up exam (P>.05, compared with baseline). No complications were observed in this patient group.

Our preliminary results revealed that transradial renal denervation is technically feasible, relatively safe, and effective for the treatment of resistant hypertension, especially where a femoral approach may not be possible.