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Efficacy of renal denervation guided by threedimensional mapping system on resistant hypertension |
JIN Xiaoqi, LIU Yanqi, FAN Tao, LU Min, ZHU Zongcheng, ZHENG Guanqun, CHEN Zhixian, SHENG Xiaodong |
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Abstract Objective To investigate the clinical efficacy and safety of renal denervation (RDN) on resistant hypertension by using pressure sensing cold salineirrigated catheter. Methods We selected 46 RH patients. All of them underwent RDN using pressure sensing cold salineirrigated catheter guided by three-dimensional mapping system CARTO. We observed the changes of blood pressure, X-ray exposure, the average operation time, the average discharge time, serum creatinine, glomerular filtration rate (GFR), renin, angiotensin Ⅱ, aldosterone and the number of antihypertensive drugs taken by these patients before and after the operation. Sixmonth follow-up was performed. ResultsThere is no renal artery traumatic complication during the operation or 6 months after the operation, and 4 cases are found postoperative local femoral artery hematoma. Blood pressure 30 min before the operation, during the operation and the first day after the operation vary statistically significantly (P<0.01). The 24hour mean systolic blood pressure [(138.42±7.62)mmHg vs.(182.46±11.25)mmHg, P<0.01] and diastolic blood pressure [(79.23±5.66) mmHg vs.(95.52±7.28) mmHg,P<0.01] are significantly decreased 6 months after the operation. The levels of renin, angiotensin Ⅱ and aldosterone 6 months after the operation are significantly lower than before (P<0.05), however, the serum creatinine level and the number of patients at the estimate GFR classification do not vary significantly (P>0.05). The number of orallytaken antihypertensive drugs significantly decrease 6 months after the operation [(3.08±0.79) vs. (4.42±1.16), P<0.05] with an average reduction of 1.34. ConclusionGuided by CARTO system, RDN therapy using pressure sensing cold salineirrigated catheter is effective and safe for RH patients.
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