Hypertension remains the leading cause of cardiovascular morbidity and mortality in spite of current medical therapies. It has been estimated that 50% of Western civilization has hypertension and approximately 20% of patients have resistant hypertension. Renal denervation (RDN) is a minimally invasive, endovascular catheter based procedure using radiofrequency ablation aimed at treating resistant hypertension. Early studies show a high degree of effectiveness in renal denervation to treat hypertension.
This book examines renal pathophysiology and the rationale for renal denervation, as well as possible long term benefits and risks of this new therapy. The myriad of devices involved in the evolution of this therapy are discussed and the book concludes with analyses of the cost effectiveness and future applications.
Cuprins
Pathophysiology: The target for renal denervation.- Physiological Rationale for Renal Denervation Therapy in Hypertension.- Preclinical Model and Histopathology Translational Medicine and Renal Denervation.- The endpoint on measuring the clinical effects of renal denervation: What are the best surrogates.- Appraisal of the Clinical Trial Data on Renal Denervation for the Management of Resistant Hypertension.- Catheter-Based Technology Alternatives for Renal Denervation: An Overview.- Medtronic ardian symplicity™ renal denervation devices.- Sympathetic Renal Denervation Using the Enlig HTN Multi-electrode Ablation System: The St Jude Experience.- Re Cor Medical Paradise® Renal Denervation System.- Therapeutic Intra Vascular Ultrasound (TIVUS).- The “One Shot” Irrigated Balloon-Mounted Spiral Electrode Renal Denervation Device.- NOVOSTE: The Brachytherapy Approach to Renal Denervation.- Perivascular Renal Denervation (PVRDTM): Chemical Renal Denervation With Micro-doses of Ethanol Using the Peregrine TM Renal Denervation Device.- Vincristine Local Delivery for Renal Artery Denervation.- Nephro Blate™ Renal Denervation System: Urologic-nephrologic Based Approach to Resistant Hypertension.- Targeted renal nerve deactivation by neurotropic agents.- Boston Scientific Vessix™ Renal Denervation System.- Radiofrequency and irrigated ablation – principles and potential for renal artery denervation (RDN) in the treatment of resistant arterial hypertension.- Renal denervation: Potential future implications beyond resistant hypertension.- Renal Denervation for Congestive Heart Failure.- Great myths of blood pressure effect size in renal denervation.- The Potential Role of Catheter-based Renal Sympathetic Denervation in Chronic and End Stage Kidney Disease.- Diabetes and Metabolic Syndrome.- Obstructive sleep apnea.
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