[Post-denervation renal artery stenosis - a matter of concern?]

Abstract

Renal denervation, an invasive technique indicated in resistant hypertension patients insufficiently controlled by antihypertensive drugs, has a good safety profile. However, an increasing number of post-denervation renal artery stenosis cases has recently been reported. We describe the case of a 49-year-old woman with resistant hypertension who was referred to our university hypertension center for renal sympathetic denervation. Her daily treatment included six antihypertensive drugs. CT angiography prior to denervation showed no renal artery stenosis or vessel wall lesions. A standard renal denervation procedure using the St Jude protocol was performed. After an initial improvement in blood pressure profile, she presented with a blood pressure impairment at 3 months after renal denervation leading to the diagnosis of a severe right renal artery stenosis.

Keywords: Dénervation rénale; Hypertension artérielle résistante; Neo-intimal thickening; Optical coherence tomography; Prolifération néo-intimale; Renal artery stenosis; Renal denervation; Resistant arterial hypertension; Sténose artérielle rénale; Sympathetic system; Système sympathique; Tomographie par cohérence optique.