Renal Sympathetic Denervation: Indications, Contemporary Devices and Future Directions

Janarthanan Sathananthan; Timothy Watson; Robert J Whitbourn; James T Stewart; Robert N Doughty; John A Ormiston; Mark WI Webster

Disclosures

Interv Cardiol. 2014;6(1):57-69. 

In This Article

Abstract and Introduction

Abstract

Hypertension has a considerable worldwide burden and is a major risk factor for cardiovascular disease. Despite the use of lifestyle measures and medical therapy, a large proportion of patients remain treatment 'resistant' and fail to have adequate control of blood pressure. This may adversely affect both future cardiovascular events and mortality. Catheter-based renal denervation is a promising contemporary evolution of a historical treatment for hypertension and aims to achieve a reduction in renal sympathetic activation. This has been shown previously to be important in both resistant hypertension and in other disease states including heart failure. This review will focus on contemporary evidence supporting the utility of renal denervation, review current and emerging devices, consider potential future treatment indications, and discuss unresolved issues that need to be addressed before renal denervation can be embraced as mainstream therapy.

Introduction

Resistant essential hypertension that does not respond to standard treatment regimens poses an important therapeutic challenge. Catheter-based sympathetic renal denervation (RDN) therapy is an exciting and promising new treatment strategy, with potential to revolutionize the current treatment paradigm in this group of patients. This review will focus on contemporary evidence supporting the utility of RDN, review current and emerging devices, consider potential future treatment indications, and discuss unresolved issues that need to be addressed before RDN can be embraced as mainstream therapy.

Comments

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