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Title: Eligibility for Renal Denervation: Anatomical Classification and Results in Essential Resistant Hypertension

PurposeTo classify the renal artery (RA) anatomy based on specific requirements for endovascular renal artery denervation (RDN) in patients with drug-resistant hypertension (RH).Materials and MethodsThe RA anatomy of 122 consecutive RH patients was evaluated by computed tomography angiography and classified as two types: A (main RA ≥20 mm in length and ≥4.0 mm in diameter) or B (main RA <20 mm in length or main RA <4.0 mm in diameter). The A type included three subtypes: A1 (without accessory RAs), A2 (with accessory RAs <3.0 mm in diameter), and A3 (with accessory RAs ≥3.0 mm in diameter]. A1 and A2 types were eligible for RDN with the Simplicity Flex catheter. Type B included twi subtypes based on the main RA length and diameter. Patients were accordingly classified into three eligibility categories: complete (CE; both RAs were eligible), partial (PE; one eligible RA), and noneligibility (NE; no eligible RA).ResultsBilateral A1 type was the most prevalent and was observed in 48.4 % of the patients followed by the A1/A2 type (18 %). CE, PE, and NE were observed in 69.7, 22.9, and 7.4 % of patients, respectively. The prevalence of accessory RAs was 41 %.ConclusionsOf RH patients, 30.3 % were not eligible for bilateral RDN with the current Simplicity Flex catheter. This classification providesmore » the basis for standardized reporting to allow for pooling of results of larger patient cohorts in the future.« less
Authors:
;  [1] ;  [2] ; ;  [3] ; ;  [2] ; ;  [4] ; ;  [2] ;  [1]
  1. Georges Pompidou European Hospital, Department of Cardiovascular and Interventional Radiology, Assistance Publique des Hôpitaux de Paris (France)
  2. Georges Pompidou European Hospital, Department of Hypertension, Assistance Publique des Hôpitaux de Paris (France)
  3. INSERM, Clinical Investigation Center 9201 (France)
  4. Kobe University Hospital, Department of Radiology and Center for Endovascular Therapy (Japan)
Publication Date:
OSTI Identifier:
22470116
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 38; Journal Issue: 1; Conference: IROS 2015: Interventional Radiological Olbert Symposium, Berlin (Germany), 15-17 Jan 2015; Other Information: Copyright (c) 2015 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANATOMY; ARTERIES; BIOMEDICAL RADIOGRAPHY; COMPUTERIZED TOMOGRAPHY; DRUGS; HYPERTENSION; KIDNEYS; LENGTH; PATIENTS