Author + information
- Received April 17, 2015
- Accepted May 7, 2015
- Published online September 1, 2015.
- Alejandro Diego-Nieto, MD, PhD∗ (, )
- Ignacio Cruz-Gonzalez, MD, PhD,
- Javier Martin-Moreiras, MD,
- Juan C. Rama-Merchan, MD, PhD,
- Javier Rodriguez-Collado, MD and
- Pedro L. Sanchez-Fernandez, MD, PhD
- ↵∗Reprint requests and correspondence:
Dr. Alejandro Diego-Nieto, Department of Cardiology, Salamanca University Hospital, Paseo de San Vicente 58, 37007 Salamanca, Spain.
We present the case of a 73-year-old woman scheduled for renal angiography for severe recurrent refractory arterial hypertension 2 months after sympathetic renal denervation with the EnligHTN multielectrode catheter system (St Jude Medical, Saint Paul, Minnesota).
The angiogram confirmed right renal artery subocclusive stenosis at the site of previous radiofrequency application (Figure 1). After catheter-balloon dilation to advance the imaging catheter, optical coherence tomography showed severe diffuse neointimal hyperplasia (Figure 2).
Since 2012, several cases of renal stenosis after renal denervation have been reported, demonstrating a wide spectrum of clinical presentation, but presenting recurrent hypertension as most relevant finding (1).
In the previous trials HTN-1 (Symplicity Renal Denervation in Patient With Refractory Hypertension) (2) and EnligHTN-I (Safety and Efficacy of Study of Renal Artery Ablation in Resistant Hypertension Patients) (3), renal artery stenosis had been attributed mainly to pre-existing artery stenosis worsening and not to a de novo procedure-related adverse event. The increasing reports of the last call into question the safety of this procedure and point to this complication as a possible cause of therapy ineffectiveness.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 17, 2015.
- Accepted May 7, 2015.
- American College of Cardiology Foundation