The Analysis Of3Clinical Cases Of Catheter-based Renal Sympathetic Denervation For Resistant Hypertension

Objective:To explore therapeutic effectiveness and safety of renal sympathetic denervation on patients with resistant hypertension.Methods:Three cases with resistant hypertension were enrolled to receive the radiofrequency Symplicity catheter-based treatment. Four to seven points at the renal artery intima were ablated spirally. Ablation indexes of each point included ablation time of2minutes, energy of5to8watts, impedance of280-320Ω and temperature of50-57℃.Results:Compared with blood pressure before renal sympathetic denervation, systolic blood pressure and diastolic blood pressure of three cases decreased obviously, accompanied by reduction in species of antihypertensive drugs of one case and decrease in dosage of antihypertensive drugs of another case. Both preoperative and postoperative serum creatinine of three cases were within normal range and had a trend of decline. Postoperative estimated glomerular filtration rate (eGFR) of three cases are increased by1.98%,28.96%and33.29%respectively, compared with preoperative eGFR. Urine protein quantitation within24hours had different trends of changes in three cases:One case had normal preoperative value of urine protein quantitation within24hours but abnormal postoperative value, which increased by32.47%compared with preoperative value; One case had both normal preoperative and postoperative value of urine protein quantitation within24hours, which increased by3.45%compared with preoperative value. One case had both abnormal preoperative value of urine protein quantitation within24hours, which decreased by38.13%compared with preoperative value. Postoperative systolic blood pressure and diastolic blood pressure of two cases decreased continuously3months later. Postoperative serum creatinine of one case had a trend of decline3months later and another case had a trend of increase. Postoperative eGFR of one case had a trend of decline3months later and another case had a trend of increase. Postoperative urine protein quantitation within24hours of one case had a trend of increase3months later and another case had a trend of decrease.Conclusions:Renal sympathetic denervation is a new effective and safe method for treatment of patients with resistant hypertension.