Ten-Year Results of Therapeutic Intravascular Ultrasound Renal Denervation in Resistant Hypertension: A Prospective Single-Center Study.

IF 2.1 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Kidney & blood pressure research Pub Date : 2026-01-01 Epub Date: 2026-03-09 DOI:10.1159/000551407

Michael Jonas, Omar Ayyad, Mohammad Alnees, Alena Kirzhner, Tal Schiller, Christian Spaulding, Abdalaziz Darwish, Ameer Mahamid, Ortal Tuvali, Adam Hassan, Haitham Abu Khadija

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引用次数: 0

Abstract

Introduction: Renal denervation (RDN) is an emerging therapy for resistant hypertension. The therapeutic intravascular ultrasound (TIVUS) system offers a nonocclusive, multidirectional approach, but its long-term efficacy and safety remain unknown.

Methods: We prospectively followed 12 patients with severe resistant hypertension who underwent bilateral ultrasound RDN as part of the TIVUS trial. Office BP was measured at baseline, 1, 3, 6, and 12 months; 24-h ambulatory BP at years 1, 2, 5, and 10. Estimated glomerular filtration rate (eGFR) and adverse events were tracked. BP changes were analyzed using mixed-effects models adjusted for baseline covariates.

Results: Mean age was 65 ± 8 years; 75% had diabetes. Baseline office BP averaged 176/84 mm Hg. The procedure was completed in all patients without complications. Systolic office BP decreased by 22.1 mm Hg at 1 month and 36.2 mm Hg at 12 months (both p < 0.001). At 10 years, office BP reductions were -38.6/-13.3 mm Hg (p < 0.001). Ambulatory BP declined from 149.4 ± 9.8 to 128.4 ± 10.0 mm Hg (ASBP) and from 85.0 ± 8.5 to 74.4 ± 9.2 mm Hg (ADBP). The 10-year change in antihypertensive defined daily doses was -1.70 (95% CI -2.75 to -0.38; p = 0.002). eGFR declined modestly (68.6 to 60.2 mL/min/1.73 m2), consistent with aging. No procedure-related adverse events occurred.

Conclusion: TIVUS ultrasound RDN achieved durable BP reduction with preserved renal function over 10 years.

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治疗性血管内超声（TIVUS）肾去神经支配治疗顽固性高血压的10年结果：一项前瞻性单中心研究。

背景：肾去神经支配（RDN）是治疗顽固性高血压的一种新兴疗法。治疗性血管内超声（TIVUS）系统提供了一种非闭塞、多方位的方法，但其长期疗效和安全性尚不清楚。目的：评价重度顽固性高血压患者使用TIVUS系统进行RDN后的10年预后。材料和方法：我们前瞻性地随访了12例接受双侧超声RDN作为TIVUS试验的一部分的患者。在基线、1、3、6和12个月测量办公室血压；第1、2、5、10年的24小时动态血压。追踪估计的肾小球滤过率（eGFR）和不良事件。使用基线协变量调整后的混合效应模型分析血压变化。结果：平均年龄65±8岁；75%的人患有糖尿病。基线办公室血压平均为176/84 mmHg。所有患者均完成RDN手术，无并发症。收缩压在1个月时下降22 mmHg (p < 0.001)，在12个月时下降37.6 mmHg （p < 0.001）。10年时，办公室血压降低为-38.7/-14.3 mmHg （p < 0.001）。动态血压也同样下降：ASBP从149.4±9.8降至128.4±10.0 mmHg （Δ≈-20），ADBP从85.0±8.5降至74.4±9.2 mmHg （Δ≈-10.6）。抗高血压定义日剂量的10年变化为-1.60 （95% CI -2.70至-0.40;p = 0.002）。eGFR适度下降（68.6 ~ 60.2 mL/min/1.73 m²），与衰老一致。无手术相关不良事件发生。结论：在10年以上的时间里，TIVUS超声RDN实现了持久的血压降低，并保留了肾功能。

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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来源期刊

Kidney & blood pressure research 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.