Resistant Hypertension Treated With Extravascular Renal Denervation

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Nephrology

Background:

• Resistant hypertension, defined as uncontrolled blood pressure despite three or more antihypertensive medications, poses a significant clinical challenge.
• Intravascular renal denervation has demonstrated limited efficacy, necessitating the exploration of alternative therapeutic strategies.
• The development of extravascular renal denervation (eRDN) aims to overcome limitations associated with the intravascular approach.

Observation:

• This report details the initial experience with the HyperQure RDN System, an extravascular renal denervation device, in two patients suffering from severe resistant hypertension.
• Significant reductions in 24-hour ambulatory blood pressure were observed at three months post-procedure in both patients.
• Both patients experienced a decrease in their reliance on oral antihypertensive medications following the eRDN procedure.

Findings:

• Case 1: Blood pressure decreased from 140/96 mm Hg to 104/70 mm Hg.
• Case 2: Blood pressure decreased from 199/117 mm Hg to 104/61 mm Hg.
• No postoperative complications were reported in either case, indicating a favorable safety profile.

Implications:

• Extravascular renal denervation (eRDN) presents a safe and effective treatment option for patients with resistant hypertension.
• eRDN may be particularly advantageous for patients with complex renal artery anatomy, where intravascular approaches are contraindicated.
• This early experience suggests eRDN could become a valuable alternative to existing renal denervation techniques.