Renal Denervation : A New Approach to Treatment of Resistant Hypertension

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. Front Matter....Pages i-xiv Pathophysiology: The Target for Renal Denervation....Pages 1-7 Physiological Rationale for Renal Denervation Therapy in Hypertension....Pages 9-13 Preclinical Model and Histopathology Translational Medicine and Renal Denervation....Pages 15-24 The Endpoint on Measuring the Clinical Effects of Renal Denervation: What Are the Best Surrogates....Pages 25-43 Appraisal of the Clinical Trial Data on Renal Denervation for the Management of Resistant Hypertension....Pages 45-57 Catheter-Based Technology Alternatives for Renal Denervation: An Overview....Pages 59-60 Medtronic Ardian SymplicityTM Renal Denervation Devices....Pages 61-68 Sympathetic Renal Denervation Using the EnligHTN Multi-electrode Ablation System: The St Jude Experience....Pages 69-79 ReCor Medical Paradise® Renal Denervation System....Pages 81-89 Therapeutic Intra Vascular Ultrasound (TIVUS)....Pages 91-96 The “OneShot” Irrigated Balloon-Mounted Spiral Electrode Renal Denervation Device....Pages 97-100 NOVOSTE: The Brachytherapy Approach to Renal Denervation....Pages 101-105 Perivascular Renal Denervation (PVRD TM ): Chemical Renal Denervation with Micro-Doses of Ethanol Using the Peregrine TM Renal Denervation Device....Pages 107-116 Vincristine Local Delivery for Renal Artery Denervation....Pages 117-123 NephroBlateTM Renal Denervation System: Urologic-Nephrologic Based Approach to Resistant Hypertension....Pages 125-134 Targeted Renal Nerve Deactivation by Neurotropic Agents....Pages 135-143 Boston Scientific VessixTM Renal Denervation System....Pages 145-146 Radiofrequency and Irrigated Ablation: Principles and Potential for Renal Artery Denervation (RDN) in the Treatment of Resistant Arterial Hypertension....Pages 147-154 Renal Denervation: Potential Future Implications Beyond Resistant Hypertension....Pages 155-161 Renal Denervation for Congestive Heart Failure....Pages 163-173 Great Myths of Blood Pressure Effect Size in Renal Denervation....Pages 175-180 The Potential Role of Catheter-Based Renal Sympathetic Denervation in Chronic and End-Stage Kidney Disease....Pages 181-189 Diabetes and Metabolic Syndrome....Pages 191-195 Obstructive Sleep Apnea....Pages 197-201 This book examines renal pathophysiology and the rationale for renal denervation (RDN), a minimally invasive, endovascular catheter based procedure using radiofrequency ablation for the treatment of resistant hypertension, a leading cause of morbidity and mortality in western civilization. In addition, the possible long term benefits and risks of this new therapy are discussed together with a description of the myriad of currently available devices and approaches involved in the evolution of this treatment. Lastly, the book focuses on the cost effectiveness of renal denervation and future directions for other possible benefits. Written by world renowned leaders in the field, Renal Denervation will be of immediate use to cardiologists, nephrologists and urologists as well as allied health professionals, device companies and anyone working in this field. Richard R. Heuser, Markus Schlaich, Horst Sievert, Editors. Includes Bibliographical References. Mode Of Access: World Wide Web.