Author + information
- Konstantinos Toutouzas, MD,
- Andreas Synetos, MD,
- Costas Tsioufis, MD,
- Charalambos Vlachopoulos, MD,
- Panagiota Pietri, MD,
- Dimitris Tousoulis, MD and
- Christodoulos Stefanadis, MD∗ ()
- ↵∗Athens Medical School, 9 Tepeleniou Strasse 15452, Paleo Psychico, Athens 15452, Greece
We read with great interest the report by Fischell et al. (1), presenting the first-in-human experience with transcatheter alcohol-mediated perivascular renal denervation using the Peregrine system. This study proved the safety and feasibility of chemical renal sympathetic denervation using microdoses of alcohol infused via microneedles into the perivascular space of the renal artery.
Despite the discouraging early results of the sham-controlled SYMPLICITY HTN-3 trial, renal denervation still offers great interest, as it deals with patients who have no other option for the treatment of resistant hypertension. Chemical renal artery denervation was first introduced (2) by our group with vincristine, a vinca alkaloid antineoplastic drug that inhibits deoxyribonucleic acid and ribonucleic acid synthesis and its potent neurotoxicity by causing giant axonal swellings and secondary demyelination, which has been used both in an experimental model (3) and in humans with resistant hypertension (4,5). In an experimental model, its local delivery by a dedicated catheter showed favorable outcomes regarding a decrease in the number of renal sympathetic nerves, leading to the assumption that this method can be used effectively to treat resistant hypertension (3,4). This was proved in the first-in-human application of chemical denervation by vincristine, which was safe and resulted in a significant decrease in systolic blood pressure in a patient with resistant hypertension (5).
The recently published data on the use of alcohol denervation are encouraging and may increase interest in chemical denervation as an alternative to radiofrequency renal denervation in specific populations.
Please note: The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- American College of Cardiology Foundation