Three-Dimensional Guided Renal Denervation to Treat Drug-Resistant Arterial Hypertension in a Patient With Renal Insufficiency

摘要

A 68-year–old diabetic women was transferred to our department for renal denervation to treat drug-resistant arterial hypertension. A known diabetic nephropathy deteriorated after an abdominal computed tomography scan in the external hospital with an increase of the serum creatinine (baseline, 1.3 mg/dL; 5 days after computed tomography, 2.1 mg/dL; at admission to our hospital, 1.4 mg/dL). To reduce or even eliminate the amount of necessary contrast medium during the denervation procedure we decided to perform a 3D guided ablation procedure.For this purpose, the external abdominal computed tomography scan was used to reconstruct the 3D anatomy of the renal arteries. The impedance-based NavX system (St Jude), used routinely in arrhythmia ablation, was used …