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Erschienen in: Clinical Research in Cardiology 5/2021

01.03.2021 | Review

Imaging strategies for safety surveillance after renal artery denervation

verfasst von: Debbie L. Cohen, Ido Weinberg, Seth Uretsky, Jeffrey J. Popma, Alexandra Almonacid, Gail Hadley, Sidney A. Cohen, Raymond R. Townsend

Erschienen in: Clinical Research in Cardiology | Ausgabe 5/2021

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Abstract

Renal denervation has emerged as a safe and effective therapy to lower blood pressure in hypertensive patients. In addition to the main renal arteries, branch vessels are also denervated in more contemporary studies. Accurate and reliable imaging in renal denervation patients is critical for long-term safety surveillance due to the small risk of renal artery stenosis that may occur after the procedure. This review summarizes three common non-invasive imaging modalities: Doppler ultrasound (DUS), computed tomography angiography (CTA), and magnetic resonance angiography (MRA). DUS is the most widely used owing to cost considerations, ease of use, and the fact that it is less invasive, avoids ionizing radiation exposure, and requires no contrast media use. Renal angiography is used to determine if renal artery stenosis is present when non-invasive imaging suggests renal artery stenosis. We compiled data from prior renal denervation studies as well as the more recent SPYRAL-HTN OFF MED Study and show that DUS demonstrates both high sensitivity and specificity for detecting renal stenosis de novo and in longitudinal assessment of renal artery patency after interventions. In the context of clinical trials DUS has been shown, together with the use of the baseline angiogram, to be effective in identifying stenosis in branch and accessory arteries and merits consideration as the main screening imaging modality to detect clinically significant renal artery stenosis after renal denervation and this is consistent with guidelines from the recent European Consensus Statement on Renal Denervation.

Graphic abstract

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Metadaten
Titel
Imaging strategies for safety surveillance after renal artery denervation
verfasst von
Debbie L. Cohen
Ido Weinberg
Seth Uretsky
Jeffrey J. Popma
Alexandra Almonacid
Gail Hadley
Sidney A. Cohen
Raymond R. Townsend
Publikationsdatum
01.03.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Research in Cardiology / Ausgabe 5/2021
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI
https://doi.org/10.1007/s00392-021-01819-w

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