OBJECTIVE

To evaluate the effect of various methods of radiofrequency sympathetic denervation of the renal arteries on effectiveness of this procedure.

MATERIAL AND METHODS

The study included 40 patients aged 18—85 years with essential resistant systolic-diastolic arterial hypertension degree 1—2 who underwent various techniques of denervation of the renal arteries under standardized triple antihypertensive therapy. In the 1^st group (n=21), denervation was performed only in proximal segment of renal artery (before the first bifurcation). In the 2^nd group (n=19), ablation was performed in proximal segment, second- and third-order branches with a diameter >3 mm, as well as in accessory renal arteries.

RESULTS

After 12 months, 1 patient from the 1^st group and 5 ones from the 2^nd group achieved target blood pressure. According to 24-hour blood pressure monitoring, mean systolic pressure in the 2^nd group decreased by 5.9 mm Hg (p<0.05). However, there was no significant decrease in diastolic blood pressure (3.8 mm Hg, p>0.05). There was no significant decrease in outpatient blood pressure within a year in the 1^st group. Seventeen patients did not give a minimal positive response (blood pressure decrease > 5 mm Hg) after renal artery denervation.

CONCLUSION

The best results were obtained after ablation of more than 27 points (in both renal arteries) including the main trunk, second- and third-order branches and accessory renal arteries with a diameter ≥3 mm. Denervation was ineffective in patients older 65 years with diabetes mellitus type II and more than 15-year history of arterial hypertension. Perhaps, these factors can be predictors of minimal or absent response to radiofrequency ablation of sympathetic nerve plexuses of the renal arteries.