Endovascular treatment of resistant and uncontrolled hypertension: therapies on the horizon

The treatment of resistant hypertension has undergone remarkable advancements in recent years. Endovascular radio frequency renal sympathetic denervation (RSD) has shown initial success in treating resistant hypertension by targeting the connection between the brain and renal sympathetic nerves. How...

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Bibliographic Details
Published in:JACC. Cardiovascular interventions 2013-01, Vol.6 (1), p.1-9
Main Authors: Bunte, Matthew C, Infante de Oliveira, Eduardo, Shishehbor, Mehdi H
Format: Article
Language:English
Subjects:
Animals
Antihypertensive Agents - therapeutic use
Blood Pressure - drug effects
Catheter Ablation
Catheters
Drug Resistance
Endovascular Procedures - adverse effects
Endovascular Procedures - instrumentation
Equipment Design
Humans
Hypertension - diagnosis
Hypertension - drug therapy
Hypertension - physiopathology
Hypertension - surgery
Hypertension - therapy
Kidney - innervation
Sympathectomy - adverse effects
Sympathectomy - instrumentation
Sympathectomy - methods
Treatment Failure
Ultrasonic Therapy
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Summary:The treatment of resistant hypertension has undergone remarkable advancements in recent years. Endovascular radio frequency renal sympathetic denervation (RSD) has shown initial success in treating resistant hypertension by targeting the connection between the brain and renal sympathetic nerves. However, the encouraging results of first-generation RSD have been tempered by important procedural limitations and a need for long-term results of safety and efficacy. In an effort to build on early clinical success, several second-generation RSD technologies are now being developed that may improve procedural safety and efficacy. Preliminary evidence for some of the latest technologies is now available. In this review, we summarize the current evidence in support of RSD and consider unique features of several new technologies that are likely to refine the endovascular treatment of resistant hypertension.
ISSN:1876-7605
DOI:10.1016/j.jcin.2012.09.005