EFFICIENCY AND SAFETY OF BIPOLAR RENAL DENERVATION AND THE ROLE OF RENAL NERVES STIMULATION IN THE PROGNOSIS OF INTERVENTION OUTCOMES

Aim. To evaluate the prognostic role of the renal nerves stimulation in the outcomes of renal denervation with a Vessix Renal Denervation system.

Methods. Ten patients (6 females, 4 males) underwent renal denervation using the Vessix Renal Denervation System (Boston Scientific, Marlborough, MA, USA). The mean age of patients was 51±13 years. All patients underwent MSCT angiography of the renal arteries before renal denervation. 1 patient had an additional renal artery. All patients underwent stimulation of the renal nerves before and after ablation with an evaluation of the blood pressure response. The following primary endpoint were evaluated: the results of invasive blood pressure moni-toring evaluation after the renal nerves stimulation before and after ablation, the results of office blood pressure measurements and 24-hours blood pressure monitoring 1 year after ablation. The rate of treatment optimization in the follow-up was assessed as well.

Results. A significant decrease in SBP and DBP was obtained during office BP monitoring and 24-hours BP monitoring within the 1 year follow-up after renal denervation. The decrease in office blood pressure was detected from the second day after ablation and maintained during the follow-up. 4 patients required less intensive medical therapy. A significant intraoperativedecrease in SBP after the renal nerves stimulation by 34.9±7.3 mm Hg was observed before ablation and 15.4±6.4 mm Hg after (p=0.048). Changes inBP response to the renal nerves stimulation before and after ablation correlated with the results of ablation. A direct correlation of high strength and statistical significance has been found between SBP and DBP response to stimulation and a decrease in office and mean daily SBP and DBP in the follow-up period.

Conclusion. The renal nerves stimulation may be used as an acute endpoint to assess the effectiveness of ablationwith the Vessix Renal Denervation System.

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