Renal ablation for treatment of hypertension without Symplicity catheter: the first human experience

Background: hypertension (htn) treatment has remained insufficient. new modalities such as “symplicity method” for the treatment of htn are a priority, especially in patients with resistant hypertension. in this study, we describe our first experience with a novel percutaneous treatment modality, without using symplicity catheter. methods: 30 patients who were resistant to at least three types of antihypertensive medical therapy were selected. patients received percutaneous renal artery denervation, without symplicity catheter method, and were followed up for 1 week, 1, 3, and 6 months later after treatment. ambulatory 24-hour blood pressure (bp) holter was performed 1 week before intervention and after 1 month. the primary outcome was change in 24-hour ambulatory bp and change in office and home-based bp measurements. results: the mean age of the studied patients was 52 ± 15.4 years and 43.3% (n = 13) were female. systolic and diastolic bp at baseline was 163 ± 17.2 and 95 ± 8.2 mmhg, respectively. patients took 3.6 ± 1.3 hypertensive medications. systolic and diastolic bp at 1-week, 1-month, 3-month and 6-month after renal denervation significantly decreased compared to the baseline (p < 0.0001). average bp derived from 24-hour ambulatory bp monitoring changed in parallel with office-based bp measurements. most of patients (50%) who underwent renal denervation had reductions of 10 mmhg or greater in systolic bp and 56.7% of them had reductions of 5 mmhg or greater in diastolic bp. 33.3% of patients also achieved the target of systolic bp less than 140 mmhg and 60% achieved the target of diastolic bp less than 90 mmhg. no patients showed vascular damage at final angiography. conclusion: catheter based renal ablation was associated with a significant reduction in both systolic and diastolic bp, on top of maximal medical therapy, which persisted throughout 6 months follow-up in the first-in-man study without the symplicity catheter.