Relevance of Targeting the Distal Renal Artery and Branches with Radiofrequency Renal Denervation Approaches—A Secondary Analysis from a Hypertensive CKD Patient Cohort

Figures

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  Figure 1. Types of renal denervation approach used. (A) Symplicity Spyral multielectrode renal denervation (RDN) catheter (Medtronic, Galway, Ireland) which allows simultaneous or sequential energy treatments into a left renal artery (each one out of four electrodes is 1 mm in length). (B) 7-Fr standard irrigated cardiac ablation catheter with a 3.5 mm electrode tip length (AlCath Flux eXtra Gold Full Circle 270°; VascoMed GmbH, Binzen, Germany) was inserted into a left renal artery and was moved in a circumferential pullback fashioned from the distal to the proximal renal artery segment. Yellow dots represent ablated spots.

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  Figure 2. Changes at 12 and 24 months of follow-up in ambulatory systolic blood pressure and diastolic blood pressure post-RDN. Data are mean ± SD (95% CI). ABPM = 24-h ambulatory blood pressure monitoring.

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  Figure 3. Correlations between change from baseline to 12 and 24 months follow-up in ambulatory systolic blood pressure after renal denervation and (A,B) number of ablated spots in total (red dots) and (C,D) distal segment summed to branches (blue dots) of renal arteries. ABPM = ambulatory blood pressure monitoring. DS = distal segment. Correlation for the number of treatments performed in the distal segment and branches were significant at both time points.

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  Figure 4. Correlations between changes from baseline to 12 and 24 months of follow-up in ambulatory diastolic blood pressure after renal denervation and (A,B) number of ablated spots in total (red dots) and (C,D) distal segment summed to branches (light green dots) of renal arteries. ABPM = ambulatory blood pressure monitoring. DS = distal segment. Correlations for the number of treatments performed in the distal segment and branches were significant at both time points.