Renal artery nerve interruption guided by location and electrical stimulation

The evidence for renal sympathetic denervation (RDN) in hypertensive patients is conflicting. Symplicity HTN-3, the only sham controlled study, proved negative although a modest overall effect of RDN is suggested. Today, no marker or functional test to guide RDN nor to establish a sufficient RDN procedure exists.

Recently, two intriguing observations have been accomplished. First, the distribution of renal sympathetic nerves in man has been studied, providing an anatomic map for denervation. Second, renal nerve stimulation (RNS) showed to induce a blood pressure increase in a human hypertension. The RNS-evoked increase was significantly blunted after RDN, thus providing an electrical map for denervation. Therefore it is hypothesized that anatomical and electrical stimulation guided and monitored renal denervation is superior compared to conventional renal denervation with respect to blood pressure reduction.

all experiments will be performed during the index procedure and 3 months after (expect for renal denervation)

- renal nerve stimulation

- renal denervation

- hyperemic pressure and flow measurements