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Radiofrequency renal sympathectomy

Radiofrequency renal sympathectomy is an ingenious, moderately invasive technique for controlling drug-resistant hypertension, a fairly common but generally underestimated condition.

Published data confirm that in the majority of European countries about 50% of hypertensive patients show resistance to pharmacological treatment. Hypertension and its consequences are known to represent s significantly increasing global health problem.

The contribution of the renal sympathetic nerve to the development and progression of hypertension has been demonstrated experimentally in preclinical and clinical studies. Renal sympathectomy by application of radiofrequency to the renal arteries has very recently become possible.
Conventional percutaneous catheterisation, generally via the femoral arteries, allows introduction into the renal arteries of a dedicated electrode through which the radiofrequency generated by a special apparatus is applied to separate points of the artery. The heat generated at the vessel wall leads to the destruction of the sympathetic fibres that run in the adventitia.
Five hundred patients have been treated worldwide to date with a positive clinical result in over 80% of cases.
A follow-up of about eighteen months has shown that the decrease in pressure is maintained, allowing pharmacological treatment to be reduced. The decrease in blood pressure correlates with a reduction in the complications of this serious, frequent condition. It is worth remembering that a reduction of 20 mm Hg in blood pressure means a threefold reduction in the risk of stroke or myocardial infarction.