Exploring Potential Referral Pathways for Renal Artery Denervation and Developing a Centre of Excellence in Ireland

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Abstract

Arterial hypertension is one of the most significant and prevalent risk factors for cardiovascular disease. Despite widespread awareness of the condition, as well as a multitude of available antihypertensive drug classes, rates of uncontrolled hypertension remain high on a global scale. Frequently, poor compliance with anti-hypertensive medication plays a big role in patients’ inability to attain adequate blood pressure control. In individuals with resistant and/or uncontrolled hypertension, renal denervation is an emerging device-based therapy that has shown to be efficacious and safe in reducing blood pressure in several sham controlled trials. Additionally, it represents a treatment option for patients intolerant to oral pharmacotherapy.

University Hospital Galway has been performing renal denervation procedures over the past number of years within multicentre, international sham-controlled trials and registries. Representing a novel and emerging antihypertensive treatment option, sources of referral for renal denervation are diverse and multiple; thus, there is an unmet need for standardised referral structures in Ireland. Herein, we review current and developing referral pathways for renal denervation at our institution, and discuss streamlined patient management and requirements to establish a centre of excellence.

探索肾动脉去势的潜在转诊途径并在爱尔兰建立卓越中心
摘要 动脉高血压是心血管疾病最重要、最普遍的风险因素之一。尽管人们对这一疾病有广泛的认识,也有多种可供选择的抗高血压药物,但在全球范围内,未得到控制的高血压发病率仍然很高。通常,抗高血压药物依从性差是导致患者无法充分控制血压的重要原因。对于耐药性高血压和/或无法控制的高血压患者,肾脏去神经支配是一种新兴的基于设备的疗法,在多项假性对照试验中,这种疗法在降低血压方面具有良好的疗效和安全性。此外,它还是不耐受口服药物治疗的患者的一种治疗选择。在过去几年中,戈尔韦大学医院一直在多中心、国际假对照试验和登记处实施肾脏去神经支配手术。作为一种新兴的降压治疗方法,肾脏去神经支配术的转诊来源多种多样;因此,爱尔兰对标准化转诊结构的需求尚未得到满足。在此,我们回顾了本机构目前和正在发展的肾脏去神经化转诊途径,并讨论了简化患者管理和建立卓越中心的要求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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