Recent trends in renal denervation devices for resistant hypertension treatment
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REVIEW ARTICLE
Recent trends in renal denervation devices for resistant hypertension treatment Sumeeyae Haribabu 1,2 & Faisal Sharif 1,2,3,4,5 & Haroon Zafar 1,2,5 Received: 5 June 2020 / Accepted: 21 October 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Hypertension is one of the most important risk factors for cardiovascular disease, which is the leading cause of mortality. The World Health Organization (WHO) estimated that in 2019 more than 1.13 billion people worldwide were suffering from hypertension. In spite of the advances in new medical therapies, control of hypertension remains suboptimal. Renal denervation (RDN) neuromodulation treatment was primarily developed to treat resistant hypertension and is potentially a new method for treating congestive heart failure, diabetes, and chronic renal failure. RDN consists of passing a catheter into the renal arteries and ablating their sympathetic nerves using radiofrequency or ultrasound energy. Despite promising results in initial trials, RDN failed to achieve its efficacy endpoints as a treatment for resistant hypertension, but the recent series of successful trials show that RDN is back as a serious treatment alternative. This paper reviews the current state-of-the-art RDN devices including Symplicity Flex, Symplicity Spyral, Vessix, EnligHTN, Iberis, TIVUS system, and Paradise. The paper also provides an in-depth review of future RDN devices which include Cryo-RDN, Golden Leaf Catheter, Synaptic, SyMapCath, ConfidenHT System, and Grizzly Microwave Ablation system. Keywords Medical devices . Renal denervation . Resistant hypertension . Sympathetic nerves
Introduction
1
Cardiovascular Research & Innovation Centre, National University of Ireland Galway, Galway, Ireland
2
Lambe Institute for Translational Research, School of Medicine, National University of Ireland Galway, Galway, Ireland
risk by 41% [3]. Among the hypertensive patients, 50% of them have their high blood pressure controlled with pharmaceutical therapies [4]. Also, 20–30% of hypertensive patients are affected by a condition called resistant hypertension, which is a condition where the blood pressure remains constantly above the normal blood pressure despite using three or more antihypertensive drugs [5]. Over the years, renal denervation (RDN) has emerged as an alternative treatment of choice to treat patients suffering from resistant hypertension [6]. Regardless of inconsistent results from RDN clinical trials, its effectiveness in controlling blood pressure level remains feasible. Previous studies showed evidence suggesting the role of sympathetic nerves in the progression of hypertension [7–9]. Currently, studies are paying attention to improve the procedure efficacy by efficient patient selection criteria and use of recent technologies along with effective comprehension of renal anatomies [10].
3
CÚRAM-SFI Centre for Research in Medical Devices, Galway, Ireland
Renal sympathetic nervous system
4
Department of Cardiology, University Hospital Galway, Galway, Ireland
5
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