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3 . 2025

Remote results after endovascular radiofrequency denervation of renal arteries in patients with resistant arterial hypertension

Abstract

Objective. This study aimed to assess the remote results of endovascular radiofrequency denervation (ERD) of renal arteries in patients with resistant arterial hypertension (AH).

Patients and methods. The study lasted 10 years. At the first stage, from a total of 284 patients with resistant AH we selected 13 patients to undergo ERD of renal arteries. These were patients who had: 1) all possible “surgical” causes of AH ruled out; 2) clearly defined AH resistant to 4-component therapy; 3) resistance of AH confirmed only by means of 24-hour ambulatory blood pressure monitoring (ABPM).

ERD was carried out using a high-frequency generator. Ablation was achieved by a Symplicity catheter with energy power supply not exceeding 8 W. The remote results of ERD of renal arteries were assessed during a period of up to 120 months. Assessment criteria: a possibility of achieving the target level of BP and pressure decrease gradient in the postoperative period.

Results and discussion. Over a 5-year follow-up, we registered reliable persistence of decreased levels of the average 24-hour systolic BP (from 217.9±24.7 to 144±8.76 mm Hg, p<0.05) and diastolic BP (from 108.2±8.7 to 91.4±13.8 mm Hg, p<0.05), as well as the time index of elevated systolic BP (from 78.2±14.6 to 49.8±29.6%, p<0.05). During 10 years of follow-up, nine (70%) patients were found to have stage 1 AH and the target level of BP on the background of minimal doses of antihypertensive drugs, as confirmed by the findings of 24-hour ambulatory blood pressure monitoring. None of the operated patients during the follow-up period after ERD demonstrated episodes of progression of heart failure.

Conclusion. With strictly defined indications for endovascular radiofrequency denervation of renal arteries, this procedure is followed by a decrease in BP and stabilization of AH for up to 10 years of the postoperative period.

Keywords: resistant arterial hypertension; renal arteries; endovascular renal sympathetic denervation; remote results; selection algorithm

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflict of interest.

Authors’ contribution. Concept and design of the study – Frolova E.V.; collection and processing of material – Frolova E.V., Morkovskikh N.V., Sukhorukov V.V., Bystrov S.A.; statistical processing – Sevryukova V.N.; writing of text – Frolova E.V.

For citation: Frolova E.V., Morkovskikh N.V., Sukhorukov V.V., Sevryukova V.N., Bystrov S.A. Remote results after endovascular radiofrequency denervation of renal arteries in patients with resistant arterial hypertension. Angiology and Vascular Surgery. Journal named after Academician A.V. Pokrovsky. 2025; 31 (3): 37–43. DOI: https://doi.org/10.33029/1027-6661-2025-31-3-37-43

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CHIEF EDITOR
CHIEF EDITOR
Yuri V. Belov
Academician of the Russian Academy of Sciences Doctor of Medical Sciences, Professor, President of the Russian Society of Angiologists and Vascular Surgeons

 

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.

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