Interventions for hypertension and stroke

Review and meta-analysis of renal artery damage following percutaneous renal denervation with radiofrequency renal artery ablation

EuroIntervention 2020;16:89-96. DOI: 10.4244/EIJ-D-19-00902

Raymond Townsend
Raymond R. Townsend1, MD; Antony Walton2, MD; Douglas A Hettrick3, PhD; Graeme L. Hickey3, PhD; Joachim Weil4, MD; Andrew S.P. Sharp5, MD; Peter J. Blankestijn6, MD; Michael Böhm7, MD; Giuseppe Mancia8, MD
1. Perlman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; 2. The Alfred Hospital, Melbourne, Australia; 3. Medtronic PLC, Santa Rosa, CA, USA; 4. Medizinische Klinik II, Sana Kliniken Lübeck, Lübeck, Germany; 5. University Hospital of Wales, Cardiff, United Kingdom; 6. Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands; 7. University Hospital of Saarland, Homburg/Saar, Germany; 8. Clinica Medica, Milan, Italy

Aims: We aimed to estimate the rate of renal artery adverse events following renal denervation with the most commonly applied radiofrequency catheter system based on a comprehensive review of published reports.

Methods and results: We reviewed 50 published renal denervation (RDN) trials reporting on procedural safety including 5,769 subjects with 10,249 patient-years of follow-up. Twenty-six patients with renal artery stenosis or dissection (0.45%) were identified of whom 24 (0.41%) required renal artery stenting. The primary meta-analysis of all reports indicated a 0.20% pooled annual incidence rate of stent implantation (95% CI: 0.12 to 0.29% per year). Additional sensitivity analyses yielded consistent pooled estimates (range: 0.17 to 0.42% per year). Median time from RDN procedure to all renal intervention was 5.5 months (range: 0 to 33 months); 79% of all events occurred within one year of the procedure. A separate review of 14 clinical trials reporting on prospective follow-up imaging using either magnetic resonance imaging, computed tomography or angiography following RDN in 511 total subjects identified just 1 new significant stenosis (0.20%) after a median of 11 months post procedure (one to 36 months).

Conclusions: Renal artery reintervention following renal denervation with the most commonly applied RF renal denervation system (Symplicity) is rare. Most events were identified within one year.

Sign in to read and download the full article

Forgot your password?

No account yet?
Sign up for free!

Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

clinical researchrenal sympathetic denervationuncontrolled hypertension
Interventions for hypertensionRenal denervation
Read next article
Long-term Outcomes of Valve-in-Valve Transcatheter Aortic Valve Implantation for Degenerate Homograft Aortic Valve Replacement

Latest news