MRI-based detection of renal artery abnormalities related to renal denervation by catheter-based radiofrequency ablation in drug resistant hypertensive patients.
Eur Radiol
; 28(8): 3355-3361, 2018 Aug.
Article
em En
| MEDLINE
| ID: mdl-29468341
ABSTRACT
OBJECTIVES:
Endovascular renal denervation (RDN) using catheter-based radiofrequency (RF) ablation has emerged as a potential treatment option for drug-resistant hypertension. Its efficacy is currently under debate. We aimed to evaluate the capability of contrast-enhanced magnetic resonance imaging (MRI) to assess the effects of RDN on the renal arterial wall in patients presenting with drug-resistant hypertension.METHODS:
Patients were included prospectively following institutional review board approval and written informed consent. Renal arteries were imaged using a two-dimensional T1-weighted TSE sequence pre- and post-administration of a gadolinium-based contrast agent, before (D0), 2 days (D2) and 6 months (M6) after RDN. Mean enhancement of the wall (mENH) and mean wall thickness (mWT) were compared across time using an ANOVA with repeated measures and post-hoc paired t-test.RESULTS:
Follow-up was completed for 23 patients (median age, 57 years; 16 men). The mENH at D2 (96.3 ± 36.0 %) was significantly higher than at D0 (61.1 ± 26.3%, p < 0.001) and M6 (66.1±22.7%, p < 0.001). Similarly, mWT was significantly higher at D2 (3.1 ± 0.4 m) than at D0 (2.7 ± 0.4mm, p < 0.001) and M6 (2.9 ± 0. 5 mm, p = 0.002).CONCLUSIONS:
MRI demonstrated abnormalities of the arterial wall 2 days after RDN that had resolved at 6 months. KEY POINTS ⢠Contrast-enhanced MRI provides anatomic evidence of renal artery RF ablation ⢠Temperature increase related to RF ablation induces transient arterial wall inflammation ⢠Morphological effects observed 2 days post RF ablation are not visible after 6 months.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artéria Renal
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Simpatectomia
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Ablação por Cateter
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Hipertensão
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Complicações Intraoperatórias
Tipo de estudo:
Diagnostic_studies
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Observational_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article