Future of catheter-based renal denervation: key issues to solve

摘要

Catheter-based renal denervation (RDN) has spread rapidly and widely.1'2 There are many positive reports1'2 showing significant blood pressure (BP) reduction; however, a negative result3 was published recently. Although this report, by Brinkmann et aP, itself has an editorial commentary,4 I would like to discuss it further. First, BP decreased gradually until 6 or 12 months after RDN1'2 in contrast to the sudden and stable BP reduction thereafter with surgical splanchnic sympathetic denervation. These findings may suggest that RDN is not simply denervation but causes damage or degeneration of the renal nerve. Second, BP reduction after RDN appeared smaller in ambulatory BP monitoring measurements than office BP measurements.