Bartuś Krzysztof, Sadowski Jerzy, Kapelak Bogusław, Litwinowicz Radosław, Zajdel Wojciech, Godlewski Jacek, Bartuś Magdalena, Zmudka Krzysztof, Chrapusta Anna, Konstanty-Kalandyk Janusz, Węgrzyn Piotr, Sobotka Paul A
Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
Kardiol Pol. 2014;72(5):425-31. doi: 10.5603/KP.a2013.0357. Epub 2014 Jan 10.
Arterial hypertension is the most common cardiovascular system disease, affecting nearly one billion people worldwide. Despite the widespread use of antihypertensive medications, in some groups of patients an optimal blood pressure (BP) cannot be achieved.
To assess BP reduction in patients with resistant hypertension after a catheter-based renal sympathetic denervation procedure and to report vascular and kidney safety in one-year follow-up.
Twenty eight patients with diagnosed resistant hypertension (median age 52.02 years, range 42-72) underwent percutaneous catheter-based renal denervation of nerve terminals in renal arteries. Arterial angiography and procedure of ablation was performed by Symplicity catheters and generator provided by Ardian (currently Medtronic Inc., USA).
Mean BP value before ablation was [mm Hg]: systolic 176.6, diastolic 100.28 and pulse pressure 73.4. After the procedure, reductions in the value of BP were reported [mm Hg]: systolic 154.8/152.54; diastolic 90.2/89.8, pulse pressure 64.66/62.73, respectively in nine-month and one-year follow-up. All results were statistically significant. No complications during one year observation were observed.
Percutaneous renal artery ablation procedure effectively reduces systolic BP, diastolic BP, and pulse pressure. No vascular or renal complications in any of the patients were observed. The results of a Polish research group showed no significant differences compared to the results obtained in the international studies Symplicity I and Symplicity II.
动脉高血压是最常见的心血管系统疾病，全球近10亿人受其影响。尽管抗高血压药物广泛使用，但在某些患者群体中，仍无法实现最佳血压（BP）。
评估经导管肾交感神经去神经术治疗顽固性高血压患者后的血压降低情况，并报告一年随访中的血管和肾脏安全性。
28例确诊为顽固性高血压的患者（中位年龄52.02岁，范围42 - 72岁）接受了经皮导管肾动脉神经末梢去神经术。动脉血管造影和消融手术由Ardian（现为美国美敦力公司）提供的Symplicity导管和发生器进行。
消融前平均血压值为[毫米汞柱]：收缩压176.6，舒张压100.28，脉压73.4。术后，在9个月和1年随访中，血压值降低情况分别为[毫米汞柱]：收缩压154.8/152.54；舒张压90.2/89.8，脉压64.66/62.73。所有结果均具有统计学意义。在一年观察期内未观察到并发症。
经皮肾动脉消融术有效降低收缩压、舒张压和脉压。未观察到任何患者出现血管或肾脏并发症。波兰研究小组的结果与国际研究Symplicity I和Symplicity II的结果相比无显著差异。
