Zdravljenje odporne arterijske hipertenzije z renalno denervacijo - da ali ne?

Abstract

The true resistant hypertension is rare. The reasons are not entirely clear, but undoubtedly the vegetative nervous system (renal afferent and efferent nerves) plays an important role. Surgical sympathectomy is effective but inappropriate due to serious side effects. In recent years, a special catheter for endovascular renal radio-frequent denervation has been developed. Using this method in accordance with the Slovenian and European recommendations, we have treated five patients with resistant hypertension. Contrary to the results of the first two non-randomized uncontrolled studies,Simplicity HTN 1 and 2, the radiofrequent ablation of renal arteries was not effective in our patients.. The third in a series of international multicentre studies--a randomized, controlled, single-blind study Simplicity HTN 3--showed, however, that renal denervation is not an effective method for the treatment of resistant hypertension. A detailed overview of enrolled patients suggests that certain patients may be eligible for intervention, but have not yet been identified.