Ten-Year Results of Therapeutic Intravascular Ultrasound Renal Denervation in Resistant Hypertension: A Prospective...

Renal denervation (RDN) is an emerging therapy for resistant hypertension. The therapeutic intravascular ultrasound (TIVUS) system offers a nonocclusive, multidirectional approach, but its long-term efficacy and safety remain unknown.

We prospectively followed 12 patients with severe resistant hypertension who underwent bilateral ultrasound RDN as part of the TIVUS trial. Office BP was measured at baseline, 1, 3, 6, and 12 months; 24-h ambulatory BP at years 1, 2, 5, and 10. Estimated glomerular filtration rate (eGFR) and adverse events were tracked. BP changes were analyzed using mixed-effects models adjusted for baseline covariates.

Mean age was 65 ± 8 years; 75% had diabetes. Baseline office BP averaged 176/84 mm Hg. The procedure was completed in all patients without complications. Systolic office BP decreased by 22.1 mm Hg at 1 month and 36.2 mm Hg at 12 months (both p < 0.001). At 10 years, office BP reductions were -38.6/-13.3 mm Hg (p < 0.001). Ambulatory BP declined from 149.4 ± 9.8 to 128.4 ± 10.0 mm Hg (ASBP) and from 85.0 ± 8.5 to 74.4 ± 9.2 mm Hg (ADBP). The 10-year change in antihypertensive defined daily doses was -1.70 (95% CI -2.75 to -0.38; p = 0.002). eGFR declined modestly (68.6 to 60.2 mL/min/1.73 m2), consistent with aging. No procedure-related adverse events occurred.

TIVUS ultrasound RDN achieved durable BP reduction with preserved renal function over 10 years.