Systematic Reviews
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World J Radiol. Jul 28, 2022; 14(7): 238-248
Published online Jul 28, 2022. doi: 10.4329/wjr.v14.i7.238
Catheter-based renal sympathetic nerve denervation on hypertension management outcomes
Som P Singh, Kevin J Varghese, Fahad M Qureshi, Macy C Anderson, John Foxworth, Mark M Knuepfer
Som P Singh, Kevin J Varghese, Fahad M Qureshi, Macy C Anderson, John Foxworth, Department of Internal Medicine, University of Missouri Kansas City School of Medicine, Kansas City, MO 64106, United States
Mark M Knuepfer, Department of Pharmacological and Physiological Science, Saint Louis University School of Medicine, Saint Louis, MO 63104, United States
Author contributions: Singh SP, Varghese KJ, Qureshi FQ, and Knuepfer MM designed the research study; Singh SP, Varghese KJ, and Qureshi FQ performed the research; Anderson MA and Foxworth J contributed critical revision; Varghese KV and Qureshi FQ analyzed the data; and All authors wrote the manuscript. All authors have read and approve the final manuscript.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Som P Singh, Academic Research, Department of Internal Medicine, University of Missouri Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO 64106, United States. somsingh@mail.umkc.edu
Received: February 14, 2022
Peer-review started: February 14, 2022
First decision: April 8, 2022
Revised: May 6, 2022
Accepted: July 5, 2022
Article in press: July 5, 2022
Published online: July 28, 2022
Processing time: 162 Days and 12.4 Hours
Abstract
BACKGROUND

Renal sympathetic denervation (RSD) provides a minimally invasive interventional treatment modality for patients with resistant hypertension. However, the post-operative outcomes remain a key area of investigation since its earliest clinical trials.

AIM

To evaluate patient outcomes after RSD intervention among peer-reviewed patient cases.

METHODS

A systematic review of literature on MEDLINE, Google Scholar, and the Cochrane Database of Systematic Reviews for RSD case studies to assess post-operative hypertension readings and medical management.

RESULTS

Among 51 RSD cases, the post-operative RSD patients report an apparent reduction with a mean number of 3.1 antihypertensive medications. The mean systolic arterial blood pressure 1 year following RSD was 136.0 mmHg (95%CI: 118.7-153.3).

CONCLUSION

The apparent improvements in office systolic blood pressure after 12 month post-operative RSD can support the therapeutic potential of this intervention for blood pressure reduction. Additional studies which utilized a uniform methodology for blood pressure measurement can further support the findings of this systematic review.

Keywords: Renal denervation; Hypertension; Systematic review; Interventional radiology; Outcomes

Core Tip: This is the first systematic review focused on peer-reviewed clinical case reports in the topic area of renal sympathetic denervation in hypertension outcomes. In addition, this study has noted the changes in blood pressure medication regimens for the management of resistant hypertension.