Renal artery and parenchymal changes after renal denervation: assessment by magnetic resonance angiography
Renal artery and parenchymal changes after renal denervation: assessment by magnetic resonance angiography
Margreet F. Sanders 0 1 2 3 5 6 7 8 9 10 12
Pieter Jan van Doormaal 0 1 2 3 5 6 7 8 9 10 12
Martine M. A. Beeftink 0 1 2 3 5 6 7 8 9 10 12
Michiel L. Bots 0 1 2 3 5 6 7 8 9 10 12
Fadl Elmula M. Fadl Elmula 0 1 2 3 5 6 7 8 9 10 12
Jesse Habets 0 1 2 3 5 6 7 8 9 10 12
Frank Hammer 0 1 2 3 5 6 7 8 9 10 12
Pavel Hoffmann 0 1 2 3 5 6 7 8 9 10 12
Lotte Jacobs 0 1 2 3 5 6 7 8 9 10 12
Patrick B. Mark 0 1 2 3 5 6 7 8 9 10 12
Alexandre Persu 0 1 2 3 5 6 7 8 9 10 11 12 13
Jean Renkin 0 1 2 3 5 6 7 8 9 10 11 12 13
Giles Roditi 0 1 2 3 5 6 7 8 9 10 12
Wilko Spiering 0 1 2 3 5 6 7 8 9 10 12
Jan A. Staessen 0 1 2 3 5 6 7 8 9 10 12
Alison H. Taylor 0 1 2 3 5 6 7 8 9 10 12
Willemien L. Verloop 0 1 2 3 5 6 7 8 9 10 12
Eva E. Vink 0 1 2 3 5 6 7 8 9 10 12
Evert-Jan Vonken 0 1 2 3 5 6 7 8 9 10 12
Michiel Voskuil 0 1 2 3 5 6 7 8 9 10 12
Tim Leiner 0 1 2 3 5 6 7 8 9 10 12
Peter J. Blankestijn 0 1 2 3 5 6 7 8 9 10 12
on behalf of the European Network COordinating research on Renal Denervation (ENCOReD) Consortium 0 1 2 3 5 6 7 8 9 10 12
0 Department of Cardiology, University Medical Center Utrecht , Utrecht , The Netherlands
1 Department of Vascular Medicine, University Medical Centre Utrecht , Utrecht , The Netherlands
2 Department of Radiology, University Medical Center Utrecht , Utrecht , The Netherlands
3 Department of Nephrology and Hypertension, University Medical Center Utrecht , PO Box 85500, 3508 GA Utrecht , The Netherlands
4 Peter J. Blankestijn
5 Department of Radiology, Glasgow Royal Infirmary , Glasgow , UK
6 Institute of Cardiovascular and Medical Sciences, University of Glasgow , Glasgow, Scotland , UK
7 Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven , Leuven , Belgium
8 Section for Interventional Cardiology, Department of Cardiology, Oslo University Hospital , Ullevål Oslo , Norway
9 Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain , Brussels , Belgium
10 Department of Internal Medicine and Department of Cardiology, Oslo University Hospital , Ullevål Oslo , Norway
11 Cardiology Department, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain , Brussels , Belgium
12 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht , Utrecht , The Netherlands
13 Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain , Brussels , Belgium
Objectives Relatively little is known about the incidence of longterm renal damage after renal denervation (RDN), a potential new treatment for hypertension. In this study the incidence of renal artery and parenchymal changes, assessed with contrast-enhanced magnetic resonance angiography (MRA) after RDN, is investigated. Methods This study is an initiative of ENCOReD, a collaboration of hypertension expert centres. Patients in whom an MRA was performed before and after RDN were included. Scans were evaluated by two independent, blinded radiologists. Primary outcome was the change in renal artery morphology and parenchyma.
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Despite promising initial results, the efficacy of renal artery
denervation (RDN) for lowering blood pressure (BP) is still
subject of discussion [1, 2]. RDN, a relatively new treatment
modality for hypertension, is achieved through an
endovascular procedure by catheter-based radiofrequency
ablation of the renal arteries [1, 3]. Because of the nature of this
intervention, there is obvious concern about possible damage
to the renal artery and parenchyma. This concern was fuelled
by the findings of Templin et al., who analysed the incidence
of renal vascular changes before and directly after RDN by
optical coherence tomography [4]. In 24 renal arteries the
authors observed a high occurrence of vascular changes;
42% of renal arteries showed vasospasm, 13% showed a
dissection and there was a significant increase in the
occurrence of oedema and thrombi [4]. The clinical significance of
these findings is not completely understood. Several case
reports demonstrated angiographically documented renal
artery stenosis after RDN [5–9]. Also, clinical studies reported
on vascular changes as assessed with renal artery imaging
before and after RDN [10–18]. Since there is considerable
variation across these studies with respect to imaging
modality, follow-up time and definitions used for
abnormalities, there is a clear need for more detailed information on
long-term safety.
The present study aimed to investigate the safety of RDN
by assessing systematically the incidence of morphological
changes in renal arteries and parenchyma after RDN,
compared to baseline, using magnetic resonance angiography
of the renal arteries and kidneys.
Material and methods
The present study is an initiative of the European Network
COo (...truncated)