Percutaneous Computer Tomography-Guided Ethanol Sympathicolysis for the Treatment of Resistant Arterial Hypertension

Purpose As an alternative to catheter-based radiofrequency (RF) ablation, renal sympathicolysis can also be achieved by image-guided percutaneous injection of ethanol around the renal artery. Materials and Methods We report the case of a 50-year-old man with refractory hypertension and end-stage ren...

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Bibliographic Details
Published in:Cardiovascular and interventional radiology 2014-04, Vol.37 (2), p.513-518
Main Authors: Streitparth, F., Gebauer, B., Nickel, P., Reinke, P., Freyhardt, P., Wieners, G., Hamm, B., Günther, R. W.
Format: Article
Language:English
Subjects:
Cardiology
Contrast Media
Ethanol - therapeutic use
Follow-Up Studies
Humans
Hypertension - complications
Hypertension - diagnosis
Hypertension - therapy
Imaging
Imaging, Three-Dimensional
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - diagnosis
Male
Medicine
Medicine & Public Health
Middle Aged
Nuclear Medicine
Radiography, Interventional
Radiology
Renal Artery - diagnostic imaging
Severity of Illness Index
Sympathectomy, Chemical - methods
Sympatholytics - therapeutic use
Technical Note
Tomography, X-Ray Computed - methods
Treatment Outcome
Ultrasound
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Summary:Purpose As an alternative to catheter-based radiofrequency (RF) ablation, renal sympathicolysis can also be achieved by image-guided percutaneous injection of ethanol around the renal artery. Materials and Methods We report the case of a 50-year-old man with refractory hypertension and end-stage renal failure of unclear etiology who was treated with computed tomography-guided percutaneous periarterial ethanol sympathicolysis. Results The procedure was painless. The patient’s BP decreased within 6 days from a baseline value of 172/84 mm Hg (1 week before treatment) to a sustained decreased value of 143/70 mm Hg 1 month after intervention, i.e. , a decrease by 29/14 mm Hg. The patient’s hypertension-related headache resolved. Conclusion Image-guided periarterial ethanol injection for renal sympathetic denervation in a patient with drug-resistant hypertension is feasible. We provide a detailed description of this new interventional procedure and discuss its potential advantages compared with catheter-based RF ablation.
ISSN:0174-1551
1432-086X
DOI:10.1007/s00270-014-0850-0