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Транскатетерная денервация почечных артерий у пациентов с резистентной артериальной гипертензией: проспективное исследование эффективности и безопасности

Транскатетерная денервация почечных артерий у пациентов с резистентной артериальной гипертензией: проспективное исследование эффективности и безопасности

Abstract

Objective. To evaluate the efficacy and safety of transcatheter renal denervation (TRD) in drug-resistant hypertension in a single-institution study (NCT01499810). Design and methods. Subjects with essential hypertension aged 18-80 years with blood pressure (BP) > 160/100 mmHg despite three or more antihypertensive drugs who signed written informed consent were included in the study. Exclusion criteria were: mean 24-h systolic BP 2, severe concomitant diseases. TRD was performed as 4-8 point radiofrequency (RF) ablations in each renal artery using standard EP catheter 5F. Efficacy endpoints: changes in office and ambulatory BP at 6 and 12 months after TRD. Safety endpoints: adverse events, changes in renal blood flow (ultrasound dopplerography) and renal function (proteinuria, serum creatinine, eGFR) at 1 st week, 6 and 12 months after TRD. Results. Interim analysis was done to monitor safety of TRD. The intervention was performed in 45 patients (aged 52,9 ± 12,2 years, 22 male), 29 patients were examined at 6 months and 16 patients — at 12 months after TRD. Intraoperative angiography showed no damage of renal arteries due to RF ablation. There were 5 minor periprocedural complications: small subcapsular kidney hematoma (80 ml by magnet-resonance tomography), contrast nephropathy, 2 access site pseudoaneurysms, allergy to dye. No additional events, significant changes in renal blood flow or renal function were found at 6 and 12 months of follow-up. Office BP fell by -34,8/-17,2 mmHg (p

Цель исследования — оценить эффективность и безопасность транскатетерной денервации почечных артерий (ТДПА) у пациентов с резистентной эссенциальной артериальной гипертензией (АГ). Материалы и методы. Критерии включения в исследование: возраст 18-80, диагноз эссенциальной АГ, артериальное давление (АД) > 160/100 мм рт. ст. на фоне приема трех и более препаратов, письменное информированное согласие. Критерии исключения: средне-суточное систолическое АД оС, 8 Ватт, 2 мин). Результаты. На момент данного анализа ТДПА выполнена у 45 пациентов, ни в одном случае не выявлено повреждения ПА в результате РЧ воздействия. В п/о периоде возникло 5 нетяжелых осложнений: небольшая субкапсулярная гематома почки (80 мл по данным магнитно-резонансной томографии); две ложные аневризмы в месте пункции, контрастная нефропатия, аллергия на контраст. Через 6 месяцев после ТДПА повторно были обследованы 29 пациентов, через 12 месяцев — 16 пациентов. Ни в одном случае не выявлено отдаленных осложнений, значимого ухудшения почечного кровотока или функции почек. Обнаружено выраженное снижение офисного АД через 6 месяцев после вмешательства, которое продолжало незначительно увеличиваться к 12-му месяцу: -34,8/-17,2 (р

Keywords

АРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯ, РАДИОЧАСТОТНАЯ АБЛАЦИЯ, ЧРЕСКОЖНЫЕ ВМЕШАТЕЛЬСТВА

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold