Renal Denervation in Treatment-Resistant Hypertension
While the use of renal denervation in the USA is currently restricted to trials, in Europe, the pressure put by marketers on interventional cardiologists and radiologists will likely contribute to further uncontrolled deployment of the technique in the absence of proven long-term benefits. Fortunately enough, several randomized controlled trials comparing renal denervation with state-of-the art drug treatment are underway, including Symplicity HTN-3 in the USA and the different European trials under the umbrella of the European Network for Coordinating RDN Research. Within 5 years, the results of most of these trials will be available and will allow a more definitive assessment of the technique. Preliminary evidence suggests that: (i) only a minority of resistant hypertensive patients are eligible for renal denervation; (ii) within this subset, the blood pressure results are less impressive and more heterogeneous than previously thought; (iii) renal denervation may favor the occurrence of complications such as renal artery stenosis.
Five-year View
While the use of renal denervation in the USA is currently restricted to trials, in Europe, the pressure put by marketers on interventional cardiologists and radiologists will likely contribute to further uncontrolled deployment of the technique in the absence of proven long-term benefits. Fortunately enough, several randomized controlled trials comparing renal denervation with state-of-the art drug treatment are underway, including Symplicity HTN-3 in the USA and the different European trials under the umbrella of the European Network for Coordinating RDN Research. Within 5 years, the results of most of these trials will be available and will allow a more definitive assessment of the technique. Preliminary evidence suggests that: (i) only a minority of resistant hypertensive patients are eligible for renal denervation; (ii) within this subset, the blood pressure results are less impressive and more heterogeneous than previously thought; (iii) renal denervation may favor the occurrence of complications such as renal artery stenosis.
Source...